TY - JOUR
T1 - Simulation Training in Neuroangiography
T2 - Transfer to Reality
AU - Kreiser, Kornelia
AU - Gehling, Kim G.
AU - Ströber, Lea
AU - Zimmer, Claus
AU - Kirschke, Jan S.
N1 - Publisher Copyright:
© 2020, The Author(s).
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Purpose: Endovascular simulation is an established and validated training method, but there is still no proof of direct patient’s benefit, defined as lower complication rate. In this study, the impact of such a training was investigated for rehearsal of patient-specific cases as well as for a structured simulation curriculum to teach angiographer novices. Materials and Methods: A total of 40 patients undergoing a diagnostic neuroangiography were randomized in a training and control group. In all training group patients, the angiographer received a patient-anatomy-specific rehearsal on a high-fidelity simulator prior to the real angiography. Radiation exposure, total duration, fluoroscopy time and amount of contrast agent of the real angiography were recorded. Silent cerebral ischemia was counted by magnetic resonance diffusion-weighted imaging (DWI). Additionally, the first 30 diagnostic neuroangiographies of six novices were compared (ntotal = 180). Three novices had undergone a structured simulation curriculum; three had acquired angiographic skills without simulation. Results: No differences were found in the number of DWI lesions or in other quality measures of the angiographies performed with and without patient-specific rehearsal. A structured simulation curriculum for angiographer novices reduced fluoroscopy time significantly and radiation exposure. The curriculum had no influence on the total duration of the examination, the amount of contrast medium or the number of catheters used. Conclusion: There was no measurable benefit of patient-anatomy-specific rehearsal for an unselected patient cohort. A structured simulation-based curriculum to teach angiographic skills resulted in a reduction of fluoroscopy time and radiation dose in the first real angiographies of novice angiographers. Level of Evidence: Level 4, part 1: randomized trial, part 2: historically controlled study.
AB - Purpose: Endovascular simulation is an established and validated training method, but there is still no proof of direct patient’s benefit, defined as lower complication rate. In this study, the impact of such a training was investigated for rehearsal of patient-specific cases as well as for a structured simulation curriculum to teach angiographer novices. Materials and Methods: A total of 40 patients undergoing a diagnostic neuroangiography were randomized in a training and control group. In all training group patients, the angiographer received a patient-anatomy-specific rehearsal on a high-fidelity simulator prior to the real angiography. Radiation exposure, total duration, fluoroscopy time and amount of contrast agent of the real angiography were recorded. Silent cerebral ischemia was counted by magnetic resonance diffusion-weighted imaging (DWI). Additionally, the first 30 diagnostic neuroangiographies of six novices were compared (ntotal = 180). Three novices had undergone a structured simulation curriculum; three had acquired angiographic skills without simulation. Results: No differences were found in the number of DWI lesions or in other quality measures of the angiographies performed with and without patient-specific rehearsal. A structured simulation curriculum for angiographer novices reduced fluoroscopy time significantly and radiation exposure. The curriculum had no influence on the total duration of the examination, the amount of contrast medium or the number of catheters used. Conclusion: There was no measurable benefit of patient-anatomy-specific rehearsal for an unselected patient cohort. A structured simulation-based curriculum to teach angiographic skills resulted in a reduction of fluoroscopy time and radiation dose in the first real angiographies of novice angiographers. Level of Evidence: Level 4, part 1: randomized trial, part 2: historically controlled study.
KW - Neuroangiography
KW - Novices
KW - Patient-specific rehearsal
KW - Silent ischemia
KW - Training
UR - http://www.scopus.com/inward/record.url?scp=85084516411&partnerID=8YFLogxK
U2 - 10.1007/s00270-020-02479-5
DO - 10.1007/s00270-020-02479-5
M3 - Article
C2 - 32394089
AN - SCOPUS:85084516411
SN - 0174-1551
VL - 43
SP - 1184
EP - 1191
JO - CardioVascular and Interventional Radiology
JF - CardioVascular and Interventional Radiology
IS - 8
ER -