Simulation-Based Virtual-Reality Patient-Specific Rehearsal Prior to Endovascular Procedures: A Systematic Review

Abstract

Patient-specific rehearsal (PsR) is a new concept whereby a procedure can be rehearsed virtually using the exact patient’s anatomical data prior to performing the real procedure. The aim of this study was to ascertain if endovascular virtual-reality PsR simulation enhanced performance in real life. This was done by performing a systematic review following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A literature search was conducted in PubMed, Embase, The Cochrane Library and Web of Science concerning PsR in endovascular procedures. All publications were handled using Covidence. Reference lists were also screened. Data extracted from the studies were realism rating, procedure time, fluoroscopy time, contrast volume, number of angiograms and reduction of errors. Kirkpatrick’s four-level model for measuring the efficiency of training was used for guidance of the relevance of studies. The search yielded 1155 results after the exclusion of duplicates, and 11 studies were included. Four studies had a control group, including one randomized trial; the remaining seven were feasibility studies. The realism was rated high, and overall, the studies showed improvements in procedure time, fluoroscopy time and contrast volume after PsR. One study assessed and confirmed the reduction in errors after PsR. Only two studies included more than 15 patients in their cohort. Kirkpatrick’s model was applied to all studies, with one study reaching level 4. All studies found the concept of PsR to be feasible and realistic. The studies with a control group showed a reduction of overall procedure time, radiation exposure and potential errors in endovascular procedures following PsR.

Audiovisual Aids in Preoperative Cardiac Surgery Education: A Scoping Review

“…In addition, these guidelines are important in the preoperative care of cardiac patients, as lack of knowledge increases anxiety and stress, in addition to greater risk for postoperative complications and morbidity and mortality in this population 15,[18][19][20] . The findings of this research elucidate the benefit of using the audiovisual aid to the detriment of standard education in health (verbal guidelines) 16,19 .…”

“…Furthermore, although there is a focus on the Nursing professional to guide the preoperative period of cardiac surgeries, some studies conclude that it is necessary to unite the multidisciplinary team, the patient and the family; in order to offer care that is fully centered on the individuals' demands, making them the very protagonists of their care [16][17][18] .…”

“…With the cancellation of surgeries and the restrictions imposed by the virus, the physicians had to adapt to a new reality where there is little contact with the surgical patient. In this way, simulation helps to customize the surgery for each patient, evaluating anatomy, surgical techniques and reducing the risk of intraoperative errors in a remote manner 16 .…”

“…Finally, audiovisual aids diversify preoperative cardiac care, enabling new approaches and experiences with the patient. They also contribute benefits for patient safety, reducing preoperative anxiety 12,[19][20] and also reduce postoperative complications, addressing performance of the cardiac surgery, resulting in shorter hospitalization times and lower hospital costs [16][17] .…”

New Trends in Vascular Imaging

“…In this special edition both case series, original research, and reviews are presented. The topics cover various vascular geometries using ultrasound, CT, MRI, and angiography [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ].…”