Novel augmented physical simulator for the training of transcatheter cardiovascular interventions (original) (raw)
Related papers
Computer simulation as a component of catheter-based training
Journal of Vascular Surgery, 2004
Introduction: Computer simulation has been used in a variety of training programs, ranging from airline piloting to general surgery. In this study we evaluate the use of simulation to train novice and advanced interventionalists in catheter-based techniques. Methods: Twenty-one physicians underwent evaluation in a simulator training program that involved placement of a carotid stent. Five participants were highly experienced in catheter-based techniques (>300 percutaneous cases), including carotid angioplasty and stenting (CAS); the remaining 16 participants were interventional novices (<5 percutaneous cases). The Procedicus VIST simulator, composed of real-time vascular imaging simulation software and a tactile interface coupled to angiographic catheters and guide wires, was used. After didactic instruction regarding CAS and use of the simulator, each participant performed a simulated CAS procedure. The participant's performance was supervised and evaluated by an expert interventionalist on the basis of 50 specific procedural steps with a maximal score of 100. Specific techniques of guide wire and catheter manipulation were subjectively assessed on a scale of 0 to 5 points based on ability. After evaluation of the initial simulated CAS procedure, each participant received a minimum of 2 hours of individualized training by the expert interventionalist, with the VIST simulator. Each participant then performed a second simulated CAS procedure, which was graded with the same scale. After completion, participants assessed the training program and its utility via survey questionnaire. Results: The average simulated score for novice participants after the training program improved significantly from 17.8 ؎ 15.6 to 69.8 ؎ 9.8 (P < .01), time to complete simulation decreased from 44 ؎ 10 minutes to 30 ؎ 8 minutes (P < .01), and fluoroscopy time decreased from 31 ؎ 7 minutes to 23 ؎ 7 minutes (P < .01). No statistically significant difference in score, total time, or fluoroscopy time was noted for experienced interventionalists. Improvement was noted in guide wire and catheter manipulation skills in novices.. Analysis of survey data from experienced interventionalists indicated that the simulated clinical scenarios were realistic and that the simulator could be a valuable tool if clinical and tactile feedback were improved. Novices also thought the simulated training was a valuable experience, and desired further training time. Conclusions: An endovascular training program using the Procedicus VIST haptic simulator resulted in significant improvement in trainee facility with catheter-based techniques in a simulated clinical setting. Novice participants derived the greatest benefit from simulator training in a mentored program, whereas experienced interventionalists did not seem to derive significant benefit. ( J Vasc Surg 2004;40:1112-7.)
EQUIPMENT AND TECHNOLOGY-Designing a Computer-Based Simulator for Interventional Cardiology Training
2000
Interventional cardiology training traditionally involves one-on-one experience following a master-apprentice model, much as other procedural disciplines. Development of a realistic computer-based training system that includes hand-eye coordination, catheter and guide wire choices, three-dimensional anatomic representations, and an integrated learning system is desirable, in order to permit learning to occur safely, without putting patients at risk. Here we present the first report of a PC-based simulator that incorporates synthetic fluoroscopy, real-time three-dimensional interactive anatomic display, and selective right-and left-sided coronary catheterization and angiography using actual catheters. Significant learning components also are integrated into the simulator. Cathet.
Simulator Training in Interventional Cardiology
Interventional Cardiology Review, 2016
Simulator training in interventional cardiology is becoming a central part of early career acquisition of technical and non-technical skills. Its use is now mandated by national training organisations. Haptic simulators, part-task trainers, immersive environments and simulated patients can provide benchmarked, reproducible and safe opportunities for trainees to develop without exposing patients to the learning curve. However, whilst enthusiasm persists and trainee-centred evidence has been encouraging, simulation does not yet have a clear link to improved clinical outcomes. In this article we describe the range of simulation options, review the evidence for their efficacy in training and discuss the delivery of training in technical skills as well as human factor training and crisis resource management. We also review the future direction and barriers to the progression of simulation training.
Designing a computer-based simulator for interventional cardiology training
Interventional cardiology training traditionally involves one-on-one experience following a master-apprentice model, much as other procedural disciplines. Development of a realistic computer-based training system that includes hand-eye coordination, catheter and guide wire choices, three-dimensional anatomic representations, and an integrated learning system is desirable, in order to permit learning to occur safely, without putting patients at risk. Here we present the first report of a PC-based simulator that incorporates synthetic fluoroscopy, real-time three-dimensional interactive anatomic display, and selective right- and left-sided coronary catheterization and angiography using actual catheters. Significant learning components also are integrated into the simulator.
VCSim3: a VR simulator for cardiovascular interventions
International journal of computer assisted radiology and surgery, 2018
Effective and safe performance of cardiovascular interventions requires excellent catheter/guidewire manipulation skills. These skills are currently mainly gained through an apprenticeship on real patients, which may not be safe or cost-effective. Computer simulation offers an alternative for core skills training. However, replicating the physical behaviour of real instruments navigated through blood vessels is a challenging task. We have developed VCSim3-a virtual reality simulator for cardiovascular interventions. The simulator leverages an inextensible Cosserat rod to model virtual catheters and guidewires. Their mechanical properties were optimized with respect to their real counterparts scanned in a silicone phantom using X-ray CT imaging. The instruments are manipulated via a VSP haptic device. Supporting solutions such as fluoroscopic visualization, contrast flow propagation, cardiac motion, balloon inflation, and stent deployment, enable performing a complete angioplasty pro...
A preliminary real-time and realistic simulation environment for percutaneous coronary intervention
BioMed research international, 2015
Percutaneous coronary intervention (PCI) is a minimally invasive surgery procedure that is widely used in the treatment of coronary artery disease. This procedure requires interventional cardiologists to have high proficiency and therefore demands an extensive training period in order to ensure successful surgical outcome. In this paper, a realistic and real-time interactive simulator for training PCI procedure is presented. A set of new approaches for core simulation components is devised and integrated into the simulator. Trainees can interact with the virtual simulation environment with real instruments and essential maneuvers encountered in real PCI procedure. Although presently targeted at PCI, our simulator could be easily extended to mimic the necessities of any vascular interventional radiology procedures by updating vascular anatomy. Preliminary validation of the proposed physical model of instruments is conducted on vascular phantom to demonstrate its performance and effec...
Journal of Vascular Surgery, 2007
Objectives: Technical proficiency in carotid artery stent (CAS) procedures is paramount to ensure patient safety. If virtual reality (VR) simulation is to be used as a valid means for credentialing physicians for CAS procedures, the assessment parameters must be able to evaluate the performance during CAS and to differentiate level of CAS experience. The aim of this study was to validate assessment parameters of a commercially available VR simulator (VIST, Vascular Interventional Surgical Trainer, Mentice, Gothenburg, Sweden) during a CAS procedure in experienced interventionalists. Methods: Forty-five interventionalists (cardiologists, radiologists, vascular surgeons) who had performed at least 100 endovascular therapeutic cases, with varying experience in CAS were recruited: groups A, n ؍ 12 (0 CAS procedures), B, n ؍ 12 (1to 20 CAS), C, n ؍ 10 (21 to 50 CAS) and D, n ؍ 11 (>50 CAS). All subjects performed a standard CAS procedure with a type I arch and were assessed by quantitative (procedure time, amount of contrast given, number of cineloops recorded, fluoroscopic time) and qualitative (clinical parameters and errors) metrics of the simulator. Participants also rated the realism and training potential of the simulator on a scale from 1 (poor) to 5 (excellent). Results: There were significant differences across the four groups A to D for procedure time (medians 20.5 vs 24 vs 19 vs 16 minutes, P ؍ .002) and fluoroscopic time (12.5 vs 13 vs 10 vs 7 minutes, P < .001), respectively. Total numbers of errors recorded by the VR simulator did not achieve statistical significance (P ؍ .209) across the four groups. All subjects rated the simulator highly (median 4) in terms of realism and training potential.
A Computer-Based Simulator for Percutaneous Coronary Intervention
Percutaneous coronary intervention (PCI) is widely used in the treatment of coronary artery disease. This procedure requires interventional cardiologists to have high proficiency and therefore demands an extensive training period to ensure successful outcome. This paper presents a computer-based interactive simulator for training PCI procedure. Trainee can interact with the virtual simulator with real instruments and basic manipulations encountered in clinical PCI procedure. Although presently targeted at PCI, our simulator could be easily extended to mimic the basic necessities of any vascular interventional radiology procedures by updating vascular anatomy.
AsiaIntervention, 2020
Aims: We developed a catheter simulator for percutaneous transvenous mitral commissurotomy (PTMC) based on the data from a patient with mitral valve stenosis. The simulator has the following characteristics: 1) the simulator is portable and easy to assemble and disassemble, 2) the cardiac portion is created using a 3D-printer, based on patient computed tomography data, 3) the simulator uses a foot-operated water pump to create pulsatile flow, and 4) the fossa ovalis in the atrial septum of the heart model is made of a thin polyurethane membrane and is interchangeable. We aimed to assess the effectiveness of this novel simulator for training in PTMC using the Inoue balloon in developing countries.