Assessing endovascular skills using the vascular interventional simulation trainer (VIST) for testing and rating coil embolization of cerebral aneurysm

Abstract

Objective: The applicability of virtual reality (VR) simulation to objective assessment of endovascular skills has been suggested. The aim of this study was to assess the role of a virtual reality simulator of interventional vascular procedures (VIST; Vascular Interventional Simulation Trainer, Mentice Corporation, Gothenburg, Sweden) in the assessment of endovascular skills required for coil embolization of cerebral aneurysms.Methods: A study was conducted in 22 trainees with various levels of expertise in basilar tip aneurysm treatment. They were divided into two groups according to experience with the coil embolization procedure either as operators or assistants: <20 cases (beginners, n=12) and >21 cases (non-beginners, n=10). Quantitative (procedure and fluoroscopy time) and qualitative (VER%) parameters were recorded and assessed by the simulator.Results: The total procedure and fluoroscopy time and average contrast media usage were the same in both groups. The VER was more than 40% in non-beginners and less than 40% in beginners, indicating that the beginners were inexperienced in performing the coil deployment procedure.Conclusion: The structured assessment correlates well with the assessment using the high-fidelity simulator. In addition to improving endovascular training, the simulators may help determine the procedural competency and credentialing standards for endovascular surgeons.