Video motion analysis in live coronary angiography differentiates levels of experience and provides a novel method of skill assessment

Rolls, Alexander; Riga, Celia; Rahim, Sybghat; Stoyanov, Danail; Herzeele, Isabelle Van; Mikhail, Ghada; Hamady, Mohamad; Cheshire, Nicholas; Bicknell, Colin

doi:10.4244/eij-d-17-00150

Cited by 4 publications

(9 citation statements)

References 27 publications

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“…Catheter tracking software. The catheter tracking software has been described previously, 5,6 so an abbreviated description is given here. A software package was created in Cþþ and using the OpenCV library (http:// opencv.willowgarage.com/) to allow video file editing and frame-accurate analysis of fluoroscopic video sequences.…”

Section: Methodsmentioning

confidence: 99%

“…The software has demonstrated robust interobserver reliability in previous studies. 5,6 The protocol for tracking in this experiment is given in the following section.…”

Section: Methodsmentioning

confidence: 99%

“…Initial studies have found that it can differentiate skill levels in simulated carotid artery stenting (CAS) and in live coronary intervention. 5,6 We use three simulated CAS cases of increasing complexity as judged by a validated scoring system 7 with the aim of using VMA to investigate the effect of anatomic complexity on endovascular performance and efficiency in CAS.…”

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confidence: 99%

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The use of video motion analysis to determine the impact of anatomic complexity on endovascular performance in carotid artery stenting

Rolls

Riga

Rahim

et al. 2019

Journal of Vascular Surgery

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Objective: Video motion analysis (VMA) uses fluoroscopic sequences to derive information on catheter and guidewire movement and is able to calculate two-dimensional catheter tip path length (PL) on the basis of frame-by-frame pixel coordinates. The objective of this study was to evaluate the effect of anatomic complexity on the efficiency of completion of defined stages of simulated carotid artery stenting as measured by VMA.Methods: Twenty interventionists each performed a standardized easy, medium, and difficult carotid artery stenting case in random order on an ANGIO Mentor (Simbionix, Airport City, Israel) simulator. Videos of all procedures were analyzed using VMA software, and performance was expressed in terms of two-dimensional guidewire tip trajectory distance (PL). Comparisons of PL were used to identify differences in cannulation performance of the participants between the three cases of varying difficulty. The procedure was subdivided into four procedural phases: arch navigation, common carotid artery (CCA) cannulation, external carotid manipulation, and carotid lesion crossing. Comparisons of PL were used to identify differences in performance between the three cases of varying difficulty for each of the procedural phases.Results: There were significant differences in PL in relation to anatomic complexity, with a stepwise increase in PL from easy to difficult cases: easy, median of 5000 pixels (interquartile range, 4075-5403 pixels); intermediate, 9059 (5974-14,553) pixels; difficult, 17,373 (11,495-26,594) pixels (P < .001). Similarly, during CCA cannulation, there was a stepwise increase in PL from easy to difficult cases: easy, 749 (603-1403) pixels; intermediate, 3274 (1544-8142) pixels; difficult, 8845 (5954-15,768) pixels (P < .001). There were no observed differences across the groups of anatomic difficulty for the phases of arch navigation, external carotid manipulation, and carotid lesion crossing.Conclusions: Increasing anatomic complexity leads to significant increases in PL of endovascular tools, in particular during CCA cannulation. This increase in tool movement may have a bearing on clinical outcome.

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Section: Methodsmentioning

confidence: 99%

“…The software has demonstrated robust interobserver reliability in previous studies. 5,6 The protocol for tracking in this experiment is given in the following section.…”

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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The use of video motion analysis to determine the impact of anatomic complexity on endovascular performance in carotid artery stenting

Rolls

Riga

Rahim

et al. 2019

Journal of Vascular Surgery

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“…However, these assessments require the presence of trained evaluators and are labour intensive. Therefore, automatically registered feedback parameters have also gained increased interest: parameters generated by VR simulators (e.g., procedure time, fluoroscopy time and contrast use during a simulated procedure), 32 information from video motion analysis (e.g., pathway length) 33 or metrics related to radiation safety (e.g., fluoroscopy time and dose area product). 11 These objective skill assessments may also help to objectify the credentialing process of upcoming vascular consultants and possibly the re-credentialing of practising experts.…”

Section: Training and Credentialingmentioning

confidence: 99%

Evidence Based Training Strategies to Improve Clinical Practice in Endovascular Aneurysm Repair

Doyen

Bicknell

Riga

et al. 2018

European Journal of Vascular and Endovascular Surgery

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“…Video motion analysis (VMA) during procedures describes the post-hoc evaluation of intra-operative movements. It has been utilised in surgical interventions to establish learning curves for surgical competence and provides objective evaluation of operator skill (17)(18)(19). For catheter-based interventions, VMA utilizes fluoroscopic sequences to derive motion-descriptive data on catheter and guide-wire movement (20).…”

Section: Introductionmentioning

confidence: 99%

Comparison of manual versus robot-assisted contralateral gate cannulation in patients undergoing endovascular aneurysm repair

et al. 2020

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PurposeRobotic endovascular technology may offer advantages over conventional manual catheter techniques. Our aim was to compare the endovascular catheter path-length (PL) for robotic versus manual contralateral gate cannulation during endovascular aneurysm repair (EVAR), using video motion analysis (VMA). MethodsThis was a multicentre retrospective cohort study with fluoroscopic video recordings of 24 EVAR cases (14 robotic, 10 manual) performed by experienced operators (>50 procedures), obtained from four leading European centres. Groups were comparable with no statistically significant differences in aneurysm size (p=0.47) or vessel tortuosity (p=0.68).Two trained assessors used VMA to calculate the catheter PL during contralateral gate cannulation for robotic versus manual approaches. ResultsThere was a high degree of inter-observer reliability (Cronbach's α>0.99) for VMA. Median robotic PL was 35.7cm [interquartile range, IQR (30.8-51.0)] versus 74.1 cm [IQR (44.3-170.4)] for manual cannulation, p=0.019. Robotic cases had a median cannulation time of 5.33mins [IQR (4.58-6.49)] versus 1.24mins [IQR (1.13-1.35)] in manual cases (p=0.0083).Generated efficiency ratios (PL/aorto-iliac centrelines) was 1.6 (1.2-2.1) in robotic cases versus 2.6 (1.7-7.0) in manual, p=0.031. ConclusionRobot-assisted contralateral gate cannulation in EVAR leads to decreased navigation path lengths and increased economy of movement compared with manual catheter techniques. The benefit could be maximised by prioritizing robotic catheter shaping over habituated reliance on guide wire manipulation. Robotic technology has the potential to reduce the endovascular footprint during manipulations even for experienced operators with the added advantage of zero radiation exposure.

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Video motion analysis in live coronary angiography differentiates levels of experience and provides a novel method of skill assessment

Abstract: VMA in coronary angiography is feasible and PL is able to differentiate levels of experience.

Cited by 4 publications

References 27 publications

The use of video motion analysis to determine the impact of anatomic complexity on endovascular performance in carotid artery stenting

The use of video motion analysis to determine the impact of anatomic complexity on endovascular performance in carotid artery stenting

Evidence Based Training Strategies to Improve Clinical Practice in Endovascular Aneurysm Repair

Comparison of manual versus robot-assisted contralateral gate cannulation in patients undergoing endovascular aneurysm repair

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