Phantoms for ultrasound-guided vascular access cannulation training: a narrative review

Abstract

The objective of this paper is to review and compare the different commercial and homemade models of ultrasound-guided vascular cannulation phantoms, as well as the methods used for the elaboration of the latter. There are a variety of simulators for ultrasound-guided puncture techniques, from simple homemade phantoms to the most sophisticated and expensive virtual reality simulators. Commercial-grade ultrasound phantoms are expensive and although they are reusable, their cost can be a barrier to simulation-based training. Homemade phantoms are a cost-effective, highly useful tool for teaching vascular access using ultrasound. For the elaboration of the homemade ones, different substances and elements are usually used to produce varied echogenicities and geometries. Specifically, animal-based ones provide more realistic tissue feedback and have a back-ground echogenicity that is closer to that of human tissue. A powerful alternative is the use of poly vinyl alcohol or modified mixtures of this material, which would be better suited to cannulation simulation with high functional fidelity.

Development, evaluation, and overview of standardized training phantoms for abdominal ultrasound-guided interventions

“…Due to the production process using powder dissolved in different quantities of liquid, it is possible to generate areas with various degrees of echogenicity. However, it is difficult to mimic muscles or fascia structures [23], and durability is restricted by rapid liquefaction at room temperature and infestation of molds due to contamination during production or usage [12,24].…”

“…Considerable evidence is available for phantoms based on variable matrices such as polymers polyvinyl alcohol (PVA), polyvinyl chloride (PVC), gelatine, silicone, and agar [10,11,12] (▶ Table 1). These matrices are complemented by target structures (tube-like vascular models, solid lesions, and fluid-filled cavities) and range from homemade phantoms, i. e., models based on pastry or porridge mainly for personal use, to high-performance simulators [13].…”