Patient-specific rehearsal of a carotid artery stenting procedure results in superior operative performance compared to a preoperative generic warm-up

Role of patient-specific virtual reality rehearsal in carotid artery stenting

“…Advances in simulation technology allow rehearsal of patient‐specific cases on the simulator, before the actual operation on the patient5. This has been referred to as ‘case’, ‘mission’ or ‘procedure’ rehearsal5–10 in analogy to the use of such technology in other industries such as the military or the domains of music and sport11–14. Here the rehearsal of complex tasks is part of established practice routines and serves to enhance the individual and team performance, minimizing procedural errors and improving safety and outcome.…”

“…In the medical domain patient-specific VR rehearsal is achieved by incorporating patient-specific image data such as information from computed tomography (CT) into the simulation 15 . Research has already indicated that it is feasible to use this technology in daily practice 15 , it can influence interventionalists in their tool choice for complex operations such as carotid artery stenting (CAS) 16 , and it may enhance endovascular performance by allowing more detailed planning of the intervention 10 .…”

Improving results for carotid artery stenting by validation of the anatomic scoring system for carotid artery stenting with patient-specific simulated rehearsal

“…The quality of the performance, as measured by expert-based ratings, declined significantly as the cases became more difficult for the GRS (median scores, 30 vs 27 vs 25; P Ͻ .0001) and the PSRS (median scores, 24 vs 22 vs 19; P Ͻ .0001; Fig 2, C). For the PSRS, the performance of the red case (median score, 19) fell under the arbitrary score of 21, indicating adequate performance. The inter-rater reliability for both rating scales was high (Cronbach ␣ ϭ 0.78 and ␣ ϭ 0.80, respectively).…”

“…15 Research has shown that these VR rehearsals resemble the real intervention, may increase operative performance, and may steer endovascular tools selection and fluoroscopy use, especially for less experienced interventionalists. [15][16][17][18][19][20] This study set out to validate the scoring system for anatomic suitability for CAS using patient-specific VR rehearsal by evaluating the performance of novice interventionalists on the simulator performing an easy, intermediate, and difficult case, as defined by the scoring system.…”

Recent Advancements in Medical Simulation: Patient‐Specific Virtual Reality Simulation

“…Face validity was established by experts, and VR rehearsal has been shown to influence both experienced and inexperienced interventionalists in their tool choice for complex procedures [40]. When using this technology in vivo on actual patients, several research groups noted a strong similarity between simulated and real procedures with regards to endovascular tool choice, fluoroscopy preferences, and access strategy [4,[39][40][41][42][43][44]. More importantly, there is data to suggest that that a full-task CAS procedure rehearsal can increase the performance of novice interventionalists performing patient-specific cases in a simulated environment compared with no preparation at all [44].…”