CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2020; 78(09): 535-540
DOI: 10.1590/0004-282X20200028
Article

Endovascular technique simulator for Neuroradiology learning

Simulador de técnica endovascular para aprendizado de Neurorradiologia
1   Centro Universitário Christus, Fortaleza CE, Brazil.
,
Edgar Marçal de BARROS FILHO
2   Instituto Universitário Virtual. Universidade Federal do Ceará, Fortaleza-CE, Brazil
,
Carlos Eduardo Barros JUCÁ
1   Centro Universitário Christus, Fortaleza CE, Brazil.
,
1   Centro Universitário Christus, Fortaleza CE, Brazil.
› Institutsangaben

ABSTRACT

Background: Vascular cerebral infarction (or stroke) is recognized as the third leading cause of death worldwide, and acute arterial occlusion comprises the main mechanism underlying ischemic stroke. Cerebrovascular diseases are treated by intracranial endovascular interventions employing minimally invasive intravascular techniques, such as neuroimaging. Conducting practical training in this area is a necessary task since patient safety is a considerably significant factor. There has been a steady increase in scientific research focused on validating endovascular simulation as a tool for training interventionists in endovascular procedures. Current literature confirms the idea that there is a beneficial role of simulation in endovascular training and skill acquisition and technique improvement. Objective: To develop an endovascular technique simulator for learning Neuroradiology. Methods: The methodology consisted of developing a simulator using 3D printing technology. Results: A literature search was carried out, commencing in August 2017, through consultation of the Medical Literature Analysis and Retrieval System Online (MEDLINE) and Latin American and Caribbean Health Sciences Literature (LILACS) databases, using the PubMed and BIREME websites, respectively. Meetings were held between the neuroradiologist specialist and programmers to develop the simulator, which was carried out in three phases: design of the arterial system, design of the prototype of the arterial system in computer graphics, and confection of the arterial system simulator in 3D. Conclusion: The simulator is ready for testing by residents and can enable the student to learn through simulations that reproduce, as realistically as possible, the situation to be subsequently experienced using a concrete tool.

RESUMO

Introdução: O acidente vascular cerebral (AVC) é a terceira causa de morte em todo o mundo e uma oclusão arterial aguda é o principal mecanismo subjacente ao AVC isquêmico. As doenças cerebrovasculares são tratadas por intervenções endovasculares intracranianas utilizando técnicas intravasculares minimamente invasivas, como a neuroimagem. Realizar treinamento prático nessa área é uma tarefa necessária, pois a segurança do paciente é um fator considerado significativo. Houve um aumento constante de pesquisas científicas focada na validação da simulação endovascular como uma ferramenta para treinar intervencionistas em procedimentos endovasculares. A literatura atual confirma a ideia de que existe um papel benéfico da simulação no treinamento endovascular e na aquisição de habilidades e aprimoramento da técnica. Objetivo: Desenvolver um simulador de técnica endovascular para o aprendizado de Neurorradiologia. Métodos: Desenvolvimento de um simulador utilizando a tecnologia de impressão em 3D. Resultados: Realizou-se uma pesquisa bibliográfica da literatura, tendo início em Agosto de 2017, com consulta feita ao banco de dados Medical Literature Analysis and Retrievel System on Line (MEDLINE) e Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS), por meio respectivamente dos sites PubMed e BIREME. Foram realizadas reuniões entre o especialista em Neurorradiologia e os programadores para desenvolver o simulador, que foi realizado em três fases: desenho do sistema arterial, desenho do protótipo do sistema arterial em computação gráfica e confecção do simulador do sistema arterial em 3D. Conclusão: O simulador está pronto para ser testado por residentes, podendo possibilitar ao aluno aprender por simulações que reproduzem, da forma mais realista possível, a situação a ser vivenciada posteriormente usando uma ferramenta concreta.



Publikationsverlauf

Eingereicht: 15. Januar 2020

Angenommen: 17. Februar 2020

Artikel online veröffentlicht:
13. Juni 2023

© 2020. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, et al. Heart disease and stroke statistics--2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009 Jan 27;119(3):e21-181. https://doi.org/10.1161/CIRCULATIONAHA.108.191261
  • 2 del Zoppo GJ, Poeck K, Pessin MS, Wolpert SM, Furlan AJ, Ferbert A, et al. Recombinant tissue plasminogen activator in acute thrombotic and embolic stroke. Ann Neurol. 1992 Jul;32(1):78-86. https://doi.org/10.1002/ana.410320113
  • 3 Kassem-Moussa, H., Gra Agnino, C. Nonocclusion and spontaneous recanalization rates in acute ischemic stroke: a review of cerebral angiography studies. Arch Neurol. 2002 Dec;59(12):1870-3. https://doi.org/10.1001/archneur.59.12.1870
  • 4 Smith WS, Sung G, Starkman S, Saver JL, Kidwell CS, Gobin YP, et al. Trial Investigators. Safety and efficacy of mechanical embolectomy in acute ischemic stroke: results of the MERCI trial. Stroke. 2005 Jul;36(7):1432-8. https://doi.org/10.1161/01.STR.0000171066.25248.1d
  • 5 Jones TH, Morawetz RB, Crowell RM, Marcoux FW, FitzGibbon SJ, DeGirolami U, et al. Thresholds of focal cerebral ischemia in awake monkeys. J Neurosurg. 1981 Jun;54(6):773-82. https://doi.org/10.3171/jns.1981.54.6.0773
  • 6 Saver JL. Time is brain-quantified. Stroke. 2006 Jan;37(1):263-6. https://doi.org/10.1161/01.STR.0000196957.55928.ab
  • 7 Day AL, Siddiqui AH, Meyers PM, Jovin TG, Derdeyn CP, Hoh BL, et al. Training standards in neuroendovascular surgery: program accreditation and practitioner certification. Stroke. 2017 Aug;48(8):2318-25. https://doi.org/10.1161/STROKEAHA.117.016560
  • 8 Kashyap VS, Ahn SS, Davis MR, Moore WS, Diethrich EB. Diethrich EB. Trends in endovascular surgery training. J Endovasc Ther. 2002 Oct;9(5):633-8. https://doi.org/10.1177/152660280200900515
  • 9 Lamont PM, Scott DJ. The impact of shortening training times on the discipline of vascular surgery in the United Kingdom. Am J Surg. 2005 Aug;190(2):269-72. https://doi.org/10.1016/j.amjsurg.2005.05.025
  • 10 Higashida RT, Hopkins LN, Berenstein A, Halbach VV, Kerber C. Program requirements for residency/fellowship education in neuroendovascular surgery/interventional neuroradiology: a special report on graduate medical education. AJNR Am J Neuroradiol. 2000 Jun-Jul;21(6):1153-9.
  • 11 Chaer RA, Derubertis BG, Lin SC, Bush HL, Karwowski JK, Birk D, et al. Simulation improves resident performance in catheter-based intervention e results of a randomized, controlled study. Ann Surg. 2006 Sep;244(3):343-52. https://doi.org/10.1097/01.sla.0000234932.88487.75
  • 12 Hsu JH, Younan D, Pandalai S, Gillespie BT, Jain RA, Schippert DW, et al. Use of computer simulation for determining endovascular skill levels in a carotid stenting model. J Vasc Surg. 2004 Dec;40(6):1118-25. https://doi.org/10.1016/j.jvs.2004.08.026
  • 13 Cates CU, Patel AD, Nicholson WJ. Use of virtual reality simulation for mission rehearsal for carotid stenting. JAMA. 2007 Jan;297(3):265-6. https://doi.org/10.1001/jama.297.3.265-b
  • 14 Nasr MK, McCarthy RJ, Hardman J, Chalmers A, Horrocks M. The increasing role of percutaneous transluminal angioplasty in the primary management of critical limb ischemia. Eur J Vasc Endovasc Surg. 2002 May;23(5):398-403. https://doi.org/10.1053/ejvs.2002.1615
  • 15 Willaert WI, Aggarwal R, Van Herzeele I, O'Donoghue K, Gaines PA, Darzi AW, et al Patient-specific endovascular simulation influences interventionalists performing carotid artery stenting procedures. Eur J Vasc Endovasc Surg. 2011 Apr;41(4):492-500. https://doi.org/10.1016/j.ejvs.2010.12.013
  • 16 Peschillo S, Caporlingua A, Colonnese C, Guidetti G. Brain AVMs: an endovascular, surgical, and radio surgical update. Sci World J. 2014 Oct;2014:834931. https://doi.org/10.1155/2014/834931
  • 17 Spiotta AM, Rasmussen PA, Masaryk TJ, Benzel EC, Schlenk R. Simulated diagnostic cerebral angiography in neurosurgical training: a pilot program. J Neurointerv Surg. 2013 Jul;5(4):376-81. https://doi.org/10.1136/neurintsurg-2012-010319
  • 18 Spiotta AM, Kellogg RT, Vargas J, Chaudry MI, Turk AS, Turner RD. D Diagnostic angiography skill acquisition with a secondary curve catheter: phase 2 of a curriculum-based endovascular simulation program. J Neurointerv Surg. 2015 Oct;7(10):777-80. https://doi.org/10.1136/neurintsurg-2014-011353
  • 19 Villanueva C, Xiong J, Rajput S. Simulation-based surgical education in cardiothoracic training. ANZ J Surg. 2019 Dec. https://doi.org/10.1111/ans.15593
  • 20 Cloft HJ, Tomsick TA, Kallmes DF, Goldstein JH, Connors JJ. Assessment of the interventional neuroradiology workforce in the United States: a review of the existing data. AJNR Am J Neuroradiol. 2002 Nov-Dec;23(10):1700-5.
  • 21 Fiorella D, Hirsch JA, Woo HH, Rasmussen PA, Shazam Hussain M, Hui FK, et al. Should neurointerventional fellowship training be suspended indefinitely? J Neurointerv Surg. 2012 Sep;4(5):315-8. https://doi.org/10.1136/neurintsurg-2012-010471
  • 22 Ribeiro de Oliveira MM, Nicolato A, Santos M, Godinho JV, Brito R, Alvarenga A, et al. Face, content, and construct validity of human placenta as a haptic training tool in neurointerventional surgery. J Neurosurg. 2016 May;124(5):1238-44. https://doi.org/10.3171/2015.1.JNS141583
  • 23 See KW, Chui KH, Chan WH, Wong KC, Chan YC. Evidence for Endovascular Simulation Training: A Systematic Review. Eur J Vasc Endovasc Surg. 2016 Mar;51(3):441-51. https://doi.org/10.1016/j.ejvs.2015.10.011