C W Kerber1, S T Hecht, K Knox. 1. Department of Radiology, University of California, San Diego, Medical Center, 92103, USA.
Abstract
PURPOSE: To develop an arteriovenous malformation (AVM) model for teaching embolization techniques and for researching and developing new interventional devices. METHODS: Open pore cellulose sponges 2 to 5 cm in diameter were coated with a watertight elastomer. One to three afferent tubes (arteries) and one large efferent tube (vein) allowed insertion of the model into a circuit of pulsatile, flowing, non-Newtonian fluid. Using fluoroscopy and angiographic imaging, five neuroradiologists practiced occluding the AVM nidus with a variety of techniques and cyanoacrylate mixtures. RESULTS: The model appeared and behaved like a human brain AVM. Attempts to teach liquid adhesive techniques were successful, and though they were stressful for the trainee, failure had none of the disastrous sequelae that attend training with human subjects. CONCLUSION: The AVM training and research model is of value in introducing physicians to the techniques needed for endovascular cyanoacrylate therapy: it allows users to develop skills at their own rates, and permits safe "failure-mode" learning.
PURPOSE: To develop an arteriovenous malformation (AVM) model for teaching embolization techniques and for researching and developing new interventional devices. METHODS: Open pore cellulose sponges 2 to 5 cm in diameter were coated with a watertight elastomer. One to three afferent tubes (arteries) and one large efferent tube (vein) allowed insertion of the model into a circuit of pulsatile, flowing, non-Newtonian fluid. Using fluoroscopy and angiographic imaging, five neuroradiologists practiced occluding the AVM nidus with a variety of techniques and cyanoacrylate mixtures. RESULTS: The model appeared and behaved like a human brain AVM. Attempts to teach liquid adhesive techniques were successful, and though they were stressful for the trainee, failure had none of the disastrous sequelae that attend training with human subjects. CONCLUSION: The AVM training and research model is of value in introducing physicians to the techniques needed for endovascular cyanoacrylate therapy: it allows users to develop skills at their own rates, and permits safe "failure-mode" learning.