title: Training models for vascular microneurosurgery.
abstract: BACKGROUND
  The number of microsurgical clippings of cerebral aneurysms is continuously decreasing. This will lead to fewer possibilities for practical training in aneurysm surgery, especially for the younger generation. Accordingly, realistic models for microsurgical training are mandatory.
  
  
  METHODS
  We present a microsurgical setup for training on a PVC rat and on a lifelike vascular training model with specific plastic vessels (PVA), and an anatomical head as well as an experimental animal model (rabbit carotid artery bifurcation model). End-to-end and end-to-side anastomoses were performed with three different levels of difficulty and three different levels of expertise on the PVC rat model. The results of the animal bifurcation aneurysm model are also described.
  
  
  RESULTS
  With increasing surgical complexity, the duration of surgery and rate of incorrect sutures of the vessel wall rise significantly. The overall patency rate of anastomosis is clearly reduced in the setup with increasing complexity grades.
  
  
  CONCLUSIONS
  The PVC rat model as well as the PVA vascular kit with realistic skull and craniotomy sites is a perfect tool for advanced microvascular anastomosis training. The experimental animal model represents a higher level of vascular surgery expertise and additionally is a perfect model for practicing appropriate clip application and clip occlusion of aneurysms.
authors.affiliation: Department of Neurosurgery, Klinikum Karlsruhe, Moltkestrasse 90, Karlsruhe, Germany. uwe.spetzger@klinikum-karlsruhe.de
authors.forename: Uwe
authors.initials: U
authors.lastname: Spetzger
authors.forename: Andrej
authors.initials: A
authors.lastname: von Schilling
authors.forename: Till
authors.initials: T
authors.lastname: Brombach
authors.forename: Gerd
authors.initials: G
authors.lastname: Winkler
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008866:Microsurgery / Q000193:education* / Q000379:methods*; D010781:Photography; D011143:Polyvinyl Chloride; D011859:Radiography; D051381:Rats; D014656:Vascular Surgical Procedures / Q000193:education* / Q000379:methods*
chemical_list: D011143:Polyvinyl Chloride