Transradial Angiography Skill Acquisition Using an Endovascular Simulation Program

World Neurosurg. 2024 Oct:190:e310-e314. doi: 10.1016/j.wneu.2024.07.120. Epub 2024 Jul 19.

Abstract

Background: Given the benefits of neuroendovascular simulation to resident education, this study aimed to assess the efficacy of simulation-based training for neuroendovascular intervention with primary and secondary catheters using a transradial approach (TRA).

Methods: Five neurosurgical residents (PGY 1-3) from our institution enrolled in a standardized pilot training protocol. Trainees used the Mentice (Gothenburg, Vastra Gotaland, Sweden) Visit G5 simulator with a type II arch using a right TRA.

Results: All participants improved their total time to complete the task from the first trial to the last trial. Residents improved the overall time required to complete the task by 111.8 ± 57 seconds (52% improvement; P = 0.012). Participants reported improved knowledge of Simmons catheter formation from 1.6 ± 0.8 to 2.8 ± 1 (P = 0.035) and improved knowledge of transradial vessel selection technique from 1.6 ± 0.9 to 2.8 ± 1.1 (P = 0.035). All residents were able to illustrate a bovine arch and types 1-3 arches post-simulation. Residents rated the simulation usefulness as 4.6 ± 0.548 (scale 1 [not useful] to 5 [essential]) with 4 of the 5 residents (80%) identifying this exercise as essential. All residents rated the hands-on component of the training exercise as the most important.

Conclusions: Residents demonstrated proficiency at Simmons catheter formation and vessel selection in a type II arch over a short time period (4 attempts and <1 hour total). Residents can use simulator-based training to increase their proficiency of vessel selection using a primary or secondary catheter for a TRA.

Keywords: Neuroendovascular; Simulation; Training; Transradial angiography.

MeSH terms

  • Clinical Competence*
  • Endovascular Procedures* / education
  • Endovascular Procedures* / methods
  • Humans
  • Internship and Residency* / methods
  • Radial Artery*
  • Simulation Training* / methods