Ongoing technological advances, especially in the field of image processing, have refined medical simulations to offer life-like replications of medical and surgical procedures in a variety of specialties. Patient-specific image data are incorporated into these simulations, and transformed into a 3D model. This enables the practitioner and his/her team to perform and practice 'real' cases on a virtual patient prior to performing the real procedure on the actual patient. This new technology has been referred to as 'patient-specific' rehearsal, also 'mission' or 'procedure' rehearsal. Research has already proven that simulated patient-specific rehearsal of a carotid artery stenting procedure may enhance surgical and team performance. The PROcedure rehearsal software can now also be used to practice patient-specific endovascular repair of infrarenal aortic aneurysms (EVAR). The ability to rehearse a challenging and complex procedure like EVAR may not only influence device selection based on preoperative planning, but also improve the technical performance of the surgeon/radiologist and the awareness and communication within the entire endovascular team. However, further research is needed to evaluate if this new technology may enhance clinical safety and efficiency, i.e. if patients actually benefit from physicians and team members conducting patient-specific rehearsals of EVAR interventions.
Study Type
OBSERVATIONAL
Enrollment
100
Sint - Maarten Hospital, Campus Rooienberg
Duffel, Belgium
Ghent University Hospital
Ghent, Belgium
Zurich University Hospital
Zurich, Switzerland
Technical operative metrics
* C-arm positioning for proximal and distal landing zone * Fluoroscopy time * Number of angiograms * Amount of contrast
Time frame: during EVAR procedure
Errors occurring during EVAR procedure (Imperial College Error Capture record)
Time frame: during EVAR procedure
Subjective sense of realism of patient-specific rehearsal reported by team members
Subjective sense of realism of patient-specific rehearsal reported by team members (Measurement: questionnaire)
Time frame: immediately after EVAR procedure
Team satisfaction
Team satisfaction Measurement: questionnaire
Time frame: immediately after EVAR procedure
Any deviation from initial treatment plan
Time frame: immediately after EVAR procedure
30 day mortality and morbidity
Time frame: within the first 30 days after surgery
Technical and clinical success rate
* Successful access to the arterial system using a remote site * Successful deployment of the endoluminal graft with secure proximal and distal fixation * Absence of either type I or III endoleak * Patent endoluminal graft without significant twist, kinks, or obstruction
Time frame: immediately after EVAR procedure
Initial clinical success
o Successful deployment of the endovascular device at the intended location, without: * Death as a result of aneurysm-related treatment * Type I or III endoleak * Graft infection or thrombosis * Aneurysm expansion (diameter \> 5mm) * Aneurysm rupture * Conversion to open repair * Graft dilatation (≥ 20% by diameter) * Graft migration * Failure of device integrity
Time frame: within the first 30 days after surgery
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