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Virtual reality simulation in carotid stenting: a new paradigm for procedural training

Nature Clinical Practice Cardiovascular Medicine volume 4, pages 174–175 (2007)Cite this article

Carotid artery stenting has recently taken on an expanded role in the treatment of cerebrovascular disease in certain patient populations who are high-risk for surgery.1 Compared with open surgery, however, endovascular interventions increase the level of procedural complexity because different skills are required and physicians must manipulate delicate intravascular devices using 2-dimensional, gray-scale, fluoroscopic guidance instead of the open visualization of traditional surgery. This difference in technique results in a significant proprioceptive–visual conflict, which must be overcome by the operator in order to perform these procedures safely and accurately.2 Endovascular intervention requires a totally different set of skills to those required when practicing traditional, open surgery, and these new skills demand a high level of cognitive and technical training to reach proficiency.

Recently, both the FDA and multispecialty clinical competency guidelines have recommended the use of virtual reality (VR) simulation training, based on objective measures of operator performance (metrics), as part of the certification and credentialing process for carotid stenting. These guidelines represent a paradigm shift for new procedural training3,4 and, as a result, high-fidelity VR simulation in carotid stent training has been widely adopted. This approach has great potential to allow inexperienced physicians to acquire meaningful new procedural skills, while their learning curve is tracked and objectively quantified,5 without jeopardizing patient safety in the process. The procedure can initially be performed in the simulation skills laboratory on virtual patients before moving to the catheterization laboratory, thereby reducing the risk to real patients.

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  1. Vascular Intervention, Emory University Hospital, Suite C–430, 1364 Clifton Road NE, Atlanta, GA 30322, USA christopher_cates@emoryhealthcare.org

Authors and Affiliations

  1. CU Cates is an Interventional Cardiologist and Director of Vascular Intervention at the Emory Hospitals, Atlanta, GA, USA.,

    Christopher U Cates

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  1. Christopher U Cates
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Cates, C. Virtual reality simulation in carotid stenting: a new paradigm for procedural training. Nat Rev Cardiol 4, 174–175 (2007). https://doi.org/10.1038/ncpcardio0837

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