• Masaaki Shojima, Yoshihiro Okamoto, Makoto Ohta, Kuniyasu Niizuma, Nobuyuki Sakai, and Teiji Tominaga.
• Department of Neurosurgery, Saitama Medical University Saitama Medical Center, Saitama, Japan. Electronic address: mshoji-tky@umin.ac.jp.
• World Neurosurg. 2020 Jul 1; 139: e827-e835.

ObjectiveSurgical skills are generally acquired by watching the "hand movements" of experts. "Eye movements" are now attracting attention in skill-learning fields. Eye-tracking technology was introduced preliminarily to develop a better skill-learning system for neuroendovascular treatments.MethodsDuring a task to place a detachable coil into a silastic cerebral aneurysm model under biplane X-ray fluoroscopy, gaze points were recorded using a head-mount eye-tracking device.ResultsDuring the task, 91% of fixations were allocated to the monitor displaying fluoroscopic images, and the others to the hands of operators or unspecified visual targets. More than 80% of fixations were located in frontal or lateral fluoroscopic images. Fixations were placed more frequently around the aneurysm than the microcatheter. One operator failed to recognize the timing when the proximal marker of the coil overlapped that of the microcatheter. The subject allocated most fixations to the frontal fluoroscopic image, whereas other subjects placed most fixations to the lateral fluoroscopic image. Furthermore, that operator put no fixations to the proximal marker of the microcatheter.ConclusionsThe results of this preliminary study imply the feasibility of the eye tracking-based learning system for neuroendovascular treatments. The eye-tracking analysis has potential in investigating or preventing procedural failures in neuroendovascular treatments.Copyright © 2020 Elsevier Inc. All rights reserved.

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