• World Neurosurg · Apr 2019

    Endovascular and Microsurgical Aneurysm Training in a Chicken Thigh and Leg Pulsatile Model.

    • Omar Tanweer, Monica C Mureb, Donato Pacione, Rajeev Sen, Jafar J Jafar, Howard A Riina, and Paul P Huang.
    • Department of Neurosurgery, New York University School of Medicine, New York, USA. Electronic address: omar.tanweer@nyumc.org.
    • World Neurosurg. 2019 Apr 1; 124: 201207201-207.

    BackgroundNeurovascular training models include animal models, synthetics, or computer simulation. In vivo models are expensive and require significant resources. Synthetic/computer models do not reflect the elasticity of fresh vessels. We describe an endovascular and microsurgical training model using a chicken thigh/leg.MethodsA total of 20 chicken thigh/leg models were obtained. Angiography was used to understand the anatomy. Proximal cannulation with a 5-French catheter was achieved and connected to a hemostatic valve with a pump to simulate pulsatile flow. Aneurysms were created at the thigh-leg junction. For clipping training, 3 types of aneurysms were created to reproduce anatomy seen in middle cerebral, anterior communicating, and posterior communicating aneurysms.ResultsThe average cost per specimen was $1.70 ± $0.30. The diameter of the proximal femoral artery was 2.4 mm ± 0.2 mm. The length from the proximal femoral artery to the aneurysm was 9.5 cm ± 0.7 cm. Distal catheterization was successful in all cases (n = 6). Successful deployment of coils and a stent was achieved under fluoroscopic guidance. Gross oversizing of coils and other mistakes led to aneurysm rupture. Each examiner performed an exploration of the pulsatile aneurysm, application and reapplication of a variety of clips, and then the final inspection of branching vessels to confirm patency.ConclusionsThe chicken thigh/leg model provides training opportunities in microsurgical suturing, endovascular techniques for aneurysm obliteration, and microsurgical reconstruction of aneurysms. It combines affordability, time efficiency, and reproducibility. Further studies measuring improvement in technical aneurysm management and comparison with other training models are warranted.Copyright © 2019 Elsevier Inc. All rights reserved.

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