Can endovascular simulators improve performance?

Abstract

AIM: The review examines if surgeons’ performances could be improved by training with endovascular simulators. METHODS: Article searches were performed via PubMed. Literature review was performed. Only articles of primary study such as randomized-controlled trials or case-series were selected. Exclusion criteria included (1) articles that were not related to endovascular procedures (2) articles that were not related to training and translation to in vivo. SUMMARY OF THE RESULTS: After excluding 114 articles, 27 were included into review. Twenty were studies on performance metrics within simulator and most of them found statistically significant improvement. Four patient-specific rehearsals were identified and the C-arm angle was affected significantly with simulation performed 24 hours before the real operation. Three randomized-controlled trials or translational studies were found and improvement on global assessment scale and procedure-specific assessment scale were revealed. CONCLUSION: Current evidence shows that performance metrics such as procedure time, fluoroscopy time and contrast volume improve with endovascular simulation. Translation to real clinical practice was proven to be successful by patient-specific rehearsals. More randomized-controlled trials should be done in order to understand if endovascular simulators can improve surgeon’s performance.