Patient-Specific Simulation of Endovascular Thoracic Aortic Repair: Initial Experience

Ann Thorac Surg. 2017 Jul;104(1):336-341. doi: 10.1016/j.athoracsur.2016.09.066.

Abstract

Purpose: Endovascular thoracic aortic repair (TEVAR) has become the treatment modality of diverse aortic pathology. We report the use of patient-specific simulation using a dedicated PROcedure Rehearsal Studio (PRS) platform (Simbionix USA Corp, Cleveland, OH) before TEVAR and evaluate the feasibility and realism of this technology.

Description: Virtual three-dimensional models of the patient's relevant anatomy were reconstructed from computed tomography data. PRS was used in 2 patients before TEVAR. In a multicenter retrospective study, we evaluated how PRS compares with real TEVAR.

Evaluation: PRS before TEVAR was feasible and demonstrated good correlation with the actual procedure. In the retrospective study, 16 patients were reconstructed (median duration, 26 minutes; interquartile range, 21 to 36 minutes). The realism of the simulated angiographies was rated highly (median, 4; interquartile range, 3 to 4). Final angiography revealed type I endoleak in 2 simulated cases and 1 real case.

Conclusion: Patient-specific rehearsal before TEVAR is feasible and permits the creation of realistic case studies; however, software updates are required to improve face validity and to foster implementation in clinical practice.

Publication types

  • Case Reports
  • Multicenter Study

MeSH terms

  • Aged
  • Aorta, Thoracic / surgery*
  • Aortic Aneurysm, Thoracic / diagnosis
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Dissection / diagnosis
  • Aortic Dissection / surgery*
  • Aortography
  • Blood Vessel Prosthesis*
  • Endovascular Procedures / education*
  • Humans
  • Imaging, Three-Dimensional*
  • Male
  • Patient Simulation*
  • Retrospective Studies
  • Tomography, X-Ray Computed