Influence of patient-specific rehearsal on operative metrics and technical success for endovascular aneurysm repair

Abstract

Introduction

Patient-specific rehearsal (PsR) is a recent technology within virtual reality (VR) simulation that lets the operators train on patient-specific data in a simulated environment prior to the procedure. Endovascular aneurysm repair (EVAR) is a complex procedure where operative metrics and technical success might improve after PsR.

Material and methods

We compared technical success and operative metrics (endovascular procedure time, contralateral gate cannulation time, fluoroscopy time, total radiation dose, number of angiograms and contrast medium use) between 30 patients, where the operators performed PsR (the PsR group), and 30 patients without PsR (the control group).

Results

The endovascular procedure time was significantly shorter in the PsR group than in the control group (median 44 versus 55 min, p = .017). The other operative metrics were similar. Technical success rates were higher in the PsR group, 96.7% primary and assisted primary outcome versus 90.0% in the control group. The differences were not significant (p = .076).

Conclusions

PsR before EVAR reduced endovascular procedure time, and our results indicate that it might improve technical success, but further studies are needed to confirm those results.

Keywords:

• Virtual reality simulator
• patient-specific rehearsal
• patient-specific simulation
• endovascular therapy
• endovascular aneurysm repair

Acknowledgements

The authors thank the surgeons and the interventional radiologists, in addition to the operating teams for participating in the study.

Declaration of interest

None of the authors state any conflict of interest or financial ties to disclose.

Additional information

Funding

The work has been supported by a grant from the Central Norway Regional Health Authority, in addition to funding from the Norwegian University of Science and Technology (NTNU), SINTEF, the medical simulation centre and the Norwegian National Advisory Unit for Ultrasound and Image-Guided Therapy at St. Olavs Hospital (all Trondheim, Norway).