Simulation in Angiography – Experiences from 5 Years Teaching, Training, and Research

Abstract

Purpose The example of university radiology/neuroradiology illustrates how high-tech angiography simulators can be used meaningfully in teaching, clinical training and research. Materials and Methods/Technical Basics A VIST LAB simulator (Mentice, Gothenburg, Sweden), which has been continuously developed both in terms of software and hardware, has been in use since 2013. Recently, the simulator has been integrated into the angiography suite Azurion (Philips, Amsterdam, Netherlands). Results/Areas of Application In student education there is the possibility for intensive examination of cerebrovascular diseases and their therapy in small group lessons. The training of beginners in diagnostic and interventional angiography begins mandatorily on the simulator. Research questions are the proof of validity and the training effect, but also the influence on patient safety and the possible cost reduction of an intervention. Conclusion As a result of continuous further development in recent years, simulators are now very well suited for both student teaching and beginner medical training. In the future, even experienced interventionalists could benefit from further technical advances, which should also be driven by academic research. Possible effects would be the reduction of examination times, complications and costs. Key Points: Citation Format

Simulation Training in Neuroangiography: Transfer to Reality

“…2) [1]. DAP was almost 20% lower in the simulation trained group (45,540 mGycm 2 /IQR 53916 vs. 55488 mGycm 2 /IQR 60697) [1], but this difference did not reach statistical significance. Alike, differences both in number of vessels probed, and number of catheters showed no difference (Table 3).…”

“…If the quality of interventional simulations, such as in aneurysm therapy, is further improved, even an advanced neurointerventionalist could benefit from simulation (training). Whether a simulation immediately preceding a treatment can prove itself-e.g., in thrombectomy-will also depend on the speed of data segmentation and the realistic implementation of state of the art devices in the simulator [1].…”

“…The group of 3 residents who underwent a structured simulation training before the first real procedure showed significantly shorter median FT than 3 residents who had not received training (FT median 7.25 min/IQR 12 vs. 11 min/IQR 10, Fig. 2) [1]. DAP was almost 20% lower in the simulation trained group (45,540 mGycm 2 /IQR 53916 vs. 55488 mGycm 2 /IQR 60697) [1], but this difference did not reach statistical significance.…”

“…The first three simulations were performed accompanied by an experienced angiographer, and every fifth procedure was also supervised. In total, the novice angiographer must have completed at least 20 diagnostic panangiographies, before he was allowed to act on a real patient [1].…”

“…As at the same time quality and informative value of non-invasive imaging are improving, the decreasing number of diagnostic angiographies reduces the possibility of physicians to acquire angiographic skills. As an alternative training method, high-fidelity simulators have been successfully tested for validity in various fields in recent years [ 1 – 3 ]. Further studies demonstrated the ability of simulators to teach how to perform a real angiography and to improve a physician’s performance by repeated training [ 4 , 5 ], but the proof of a direct benefit for an individual patient is still pending [ 5 – 7 ].…”