Virtual Reality Simulation in the Endovascular Field

Virtual Reality Simulation in the Endovascular Field

Aggarwal Rajesh , Herzeele Isabelle Van
US Cardiology - Volume 5 - Issue I
Published: August 2008
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The last decade has witnessed exponential growth in the field of endovascular interventions, although only in the last few years has there been a widespread interest in the carotid artery stent (CAS). Endovascular physicians with different medical backgrounds such as interventional cardiologists, radiologists, and vascular surgeons all recognize the importance of this changing technology.1This procedure is almost unique, as the risks to the patient (stroke and death) as a result of the physician’s learning curve are unacceptably high. This has been summarized by editorials written after the publication of the Carotid and Vertebral Artery Angioplasty Study (CAVATAS)2–4 and the Endarterectomy versus Angioplasty in Patients with Symptomatic Severe Carotid Stenosis trial (EVA-3S).5–7 Recent publications of the rates of medical errors and adverse events within healthcare8 have drawn the spotlight toward methods of establishing credentials for physicians preparing to perform complex procedures. In order to improve patient safety, operators must have the appropriate cognitive and technical skills and experience of CAS. Furthermore, physicians should have previously achieved a high level of proficiency in other catheter-based interventions and completed dedicated training in CAS.9,10

Traditional methods have focused on meeting a minimum number of procedures and on the duration of training to ensure competence, inappropriately correlating experience with competence.11,12 What is needed, given the complexity and risk of CAS plus the conflicting skill sets of physicians across several subspecialties, is a standardized and objective method for assessing procedural performance. Within aviation and in other medical fields such as laparoscopy, virtual reality (VR) simulation is able to train and objectively assess technical performance, and subsequently to define the benchmark level of skill.13–15 Therefore, the three specialties involved in the treatment of CAS have joined forces and launched the European Virtual Reality Endovascular Research Team (EVEREST). The ultimate goal of this group is to improve the training of current and future endovascular therapists.

In this article, an overview of different endovascular VR simulators and validation studies will be given, highlighting the role of the EVEREST members. Additionally, the possible benefits of VR simulation in the endovascular field, integration of VR simulation within a proficiency-based endovascular curriculum, and future applications will be explained.

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