Neuroangiography simulation using a silicone model in the angiography suite improves trainee skills.
OBJECTIVE
Simulation techniques in neurosurgical training are becoming more important. The purpose of this study was to determine whether silicone vascular models used in the angiography suite can render improvement in trainee performance and safety in neuroendovascular procedures.


METHODS
10 residents from neurosurgery and radiology training programs were asked to perform a diagnostic angiogram on a silicone based vascular model (United Biologics, Tustin, USA). This was done in the angiography suite with the full biplane fluoroscopy machine (Siemens, Munich, Germany). On their first attempt, they were coached by a faculty member trained in endovascular neurosurgery; on their second attempt, they received coaching only if the procedure had stalled. Technique was scored on multiple criteria by the faculty, and total time and fluoroscopy time were recorded on both attempts.


RESULTS
In this group of 10 residents, overall procedure time significantly decreased from 51 to 42 min (p=0.01), and total fluoro time significantly decreased from 12 to 9 min (p=0.002) between the first attempt and the second attempt. Technical skill increased significantly in navigation, vessel selection, projection setup, and road map usage.


CONCLUSIONS
Silicone vascular models used in the angiography suite, with the clinical working tools and biplane fluoroscopy, provide a valuable experience for training residents in diagnostic angiography, and improved performance and safety.
Department of Neurologic Surgery, University of Wisconsin, Madison, Wisconsin, USA.
Amrendra S
AS
Miranpuri
Department of Neurologic Surgery, University of Wisconsin, Madison, Wisconsin, USA.
Christopher M
CM
Nickele
Department of Surgery, Division of Neurosurgery, University of Vermont, Burlington, Vermont, USA.
Erinc
E
Akture
Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin, USA Siemens Medical Solutions, Hoffman Estates, Illinois, USA.
Kevin
K
Royalty
Department of Neurologic Surgery, University of Wisconsin, Madison, Wisconsin, USA.
David B
DB
Niemann
D002983:Clinical Competence; D003198:Computer Simulation; D004521:Educational Measurement; D057510:Endovascular Procedures / Q000379:methods; D005451:Fluorescein Angiography / Q000379:methods*; D006801:Humans; D007396:Internship and Residency; D008348:Manikins; D059906:Neuroimaging; D009493:Neurosurgery / Q000193:education*; D011871:Radiology / Q000193:education*; D012828:Silicones
D012828:Silicones
Angiography; Device; Technique; Technology