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Original research
Neuroangiography simulation using a silicone model in the angiography suite improves trainee skills
  1. Amrendra S Miranpuri1,
  2. Christopher M Nickele1,
  3. Erinc Akture2,
  4. Kevin Royalty3,4,
  5. David B Niemann1
  1. 1Department of Neurologic Surgery, University of Wisconsin, Madison, Wisconsin, USA
  2. 2Department of Surgery, Division of Neurosurgery, University of Vermont, Burlington, Vermont, USA
  3. 3Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin, USA
  4. 4Siemens Medical Solutions, Hoffman Estates, Illinois, USA
  1. Correspondence to Dr D B Niemann, Department of Neurologic Surgery, University of Wisconsin Hospital and Clinics, 600 Highland Avenue, CSC K4/858, Madison, WI 53792, USA; d.niemann{at}


Purpose Simulation techniques in neurosurgical training are becoming more important. The purpose of this study was to determine whether silicone vascular models used in the angiography suite can render improvement in trainee performance and safety in neuroendovascular procedures.

Methods 10 residents from neurosurgery and radiology training programs were asked to perform a diagnostic angiogram on a silicone based vascular model (United Biologics, Tustin, USA). This was done in the angiography suite with the full biplane fluoroscopy machine (Siemens, Munich, Germany). On their first attempt, they were coached by a faculty member trained in endovascular neurosurgery; on their second attempt, they received coaching only if the procedure had stalled. Technique was scored on multiple criteria by the faculty, and total time and fluoroscopy time were recorded on both attempts.

Results In this group of 10 residents, overall procedure time significantly decreased from 51 to 42 min (p=0.01), and total fluoro time significantly decreased from 12 to 9 min (p=0.002) between the first attempt and the second attempt. Technical skill increased significantly in navigation, vessel selection, projection setup, and road map usage.

Conclusions Silicone vascular models used in the angiography suite, with the clinical working tools and biplane fluoroscopy, provide a valuable experience for training residents in diagnostic angiography, and improved performance and safety.

  • Technology
  • Technique
  • Angiography
  • Device

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