# Validation of simulator-based neuroangiographical training

## TL;DR

This study shows that simulator-based training improves skills in neuroangiography, with trainees approaching expert levels after repeated practice.

## Contribution

The study validates endovascular simulators as effective tools for training and assessing neuroangiographic skills.

## Key findings

- Trainees showed significant improvement in performance metrics after repeated simulator use.
- Endovascular simulators can effectively differentiate between trainee and expert performance.
- Simulator training enables skill acquisition in a controlled setting for neuroendovascular procedures.

## Abstract

Angiography is a diagnostic and interventional technique in (endo)vascular neurosurgery that demands a high level of precision and technical expertise. Traditionally, mastery of angiographic techniques has relied on hands-on training, often limited by patient availability and procedural complexity. This study aims to investigate the effectiveness of simulator-based training for angiography, determining its role in enhancing procedural proficiency and its potential integration into a neuroendovascular training curriculum.

Is a simulator-based training for neuroangiography effective ?

Participants (22 trainees and 10 experts) were recruited in neurosurgical departments from four international university hospitals. After a familiarization session, each participant performed 6 attempts of diagnostic angiography and 3 attempts of coiling on an Angio mentor endovascular simulator. Data gathered were procedure time, fluoroscopy time, amount of contrast injected, number of roadmap sequences and number of errors. The learning curve was studied and contrasting group assessment was performed.

There was a clear steep improvement for all parameters in the learning curve which flattens out as the trainees master angiography and coiling. Trainees had a notable reduction in procedure time, approaching the experts' levels after sixth and seventh attempt of diagnostic angiography. The contrasting group assessment demonstrated discriminating results of experts compared to trainees and a distinctly increasing overlap between trainees and experts with increasing number of attempts.

Endovascular simulators enable skill acquisition in a controlled environment, enhancing technical proficiency in neuroendovascular coiling and angiography, and should play a role in neuroendovascular training.

•There is a steep learning curve for the trainees for the performance of a diagnostic angiography and coiling on endovascular simulators•Endovascular simulators are valid tools to demonstrate expertise in neuroangiography•Endovascular simulators enable skill acquisition in a controlled environment•Endovascular simulators should play a role in neuroendovascular training.

There is a steep learning curve for the trainees for the performance of a diagnostic angiography and coiling on endovascular simulators

Endovascular simulators are valid tools to demonstrate expertise in neuroangiography

Endovascular simulators enable skill acquisition in a controlled environment

Endovascular simulators should play a role in neuroendovascular training.