Human Thiel-Embalmed Cadaveric Aortic Model with Perfusion for Endovascular Intervention Training and Medical Device Evaluation

Helen McLeod; Ben F. Cox; James Robertson; Robyn Duncan; Shona Matthew; Raj Bhat; Avril Barclay; J. Anwar; Tracey Wilkinson; Andreas Melzer; J. Graeme Houston

doi:10.1007/s00270-017-1643-z

Human Thiel-Embalmed Cadaveric Aortic Model with Perfusion for Endovascular Intervention Training and Medical Device Evaluation

Helen McLeod, Ben F. Cox, James Robertson, Robyn Duncan, Shona Matthew, Raj Bhat, Avril Barclay, J. Anwar, Tracey Wilkinson, Andreas Melzer, J. Graeme Houston^*

^*Corresponding author for this work

Clinical Sciences

Research output: Contribution to journal › Article › peer-review

11 Citations (Scopus)

Abstract

Purpose: The purpose of this investigation was to evaluate human Thiel-embalmed cadavers with the addition of extracorporeal driven ante-grade pulsatile flow in the aorta as a model for simulation training in interventional techniques and endovascular device testing. Materials and Methods: Three human cadavers embalmed according to the method of Thiel were selected. Extracorporeal pulsatile ante-grade flow of 2.5 L per min was delivered directly into the aorta of the cadavers via a surgically placed connection. During perfusion, aortic pressure and temperature were recorded and optimized for physiologically similar parameters. Pre- and post-procedure CT imaging was conducted to plan and follow up thoracic and abdominal endovascular aortic repair as it would be in a clinical scenario. Thoracic endovascular aortic repair (TEVAR) and endovascular abdominal repair (EVAR) procedures were conducted in simulation of a clinical case, under fluoroscopic guidance with a multidisciplinary team present. Results: The Thiel cadaveric aortic perfusion model provided pulsatile ante-grade flow, with pressure and temperature, sufficient to conduct a realistic simulation of TEVAR and EVAR procedures. Fluoroscopic imaging provided guidance during the intervention. Pre- and post-procedure CT imaging facilitated planning and follow-up evaluation of the procedure. Conclusion: The human Thiel-embalmed cadavers with the addition of extracorporeal flow within the aorta offer an anatomically appropriate, physiologically similar robust model to simulate aortic endovascular procedures, with potential applications in interventional radiology training and medical device testing as a pre-clinical model.

Original language	English
Pages (from-to)	1454-1460
Number of pages	7
Journal	Cardiovascular and Interventional Radiology
Volume	40
Issue number	9
DOIs	https://doi.org/10.1007/s00270-017-1643-z
Publication status	Published - 1 Sept 2017

Bibliographical note

Funding Information:
This work was funded by Dr Hadwen Trust. The Dr Hadwen Trust (DHT) is the UK’s leading non-animal biomedical research charity that exclusively funds and promotes human-relevant research that replaces the use of animal’s while supporting the progress of medicine. This project has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration under Grant agreement no 324487. This work followed on from EU 7th Framework-funded IIIOS (FP7/2007-2013, under Grant agreement no 238802). The researchers are very grateful to Professor Sir Alfred Cuschieri for the use of equipment during this research. We would like to thank the people who made this work possible by the generous donation of their bodies to medical research and science.

Publisher Copyright:
© 2017, The Author(s).

Keywords

Cadaveric perfusion
Endovascular aortic aneurysm repair (EVAR)
Endovascular training

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

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10.1007/s00270-017-1643-z

Cite this

McLeod, H., Cox, B. F., Robertson, J., Duncan, R., Matthew, S., Bhat, R., Barclay, A., Anwar, J., Wilkinson, T., Melzer, A., & Houston, J. G. (2017). Human Thiel-Embalmed Cadaveric Aortic Model with Perfusion for Endovascular Intervention Training and Medical Device Evaluation. Cardiovascular and Interventional Radiology, 40(9), 1454-1460. https://doi.org/10.1007/s00270-017-1643-z

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abstract = "Purpose: The purpose of this investigation was to evaluate human Thiel-embalmed cadavers with the addition of extracorporeal driven ante-grade pulsatile flow in the aorta as a model for simulation training in interventional techniques and endovascular device testing. Materials and Methods: Three human cadavers embalmed according to the method of Thiel were selected. Extracorporeal pulsatile ante-grade flow of 2.5 L per min was delivered directly into the aorta of the cadavers via a surgically placed connection. During perfusion, aortic pressure and temperature were recorded and optimized for physiologically similar parameters. Pre- and post-procedure CT imaging was conducted to plan and follow up thoracic and abdominal endovascular aortic repair as it would be in a clinical scenario. Thoracic endovascular aortic repair (TEVAR) and endovascular abdominal repair (EVAR) procedures were conducted in simulation of a clinical case, under fluoroscopic guidance with a multidisciplinary team present. Results: The Thiel cadaveric aortic perfusion model provided pulsatile ante-grade flow, with pressure and temperature, sufficient to conduct a realistic simulation of TEVAR and EVAR procedures. Fluoroscopic imaging provided guidance during the intervention. Pre- and post-procedure CT imaging facilitated planning and follow-up evaluation of the procedure. Conclusion: The human Thiel-embalmed cadavers with the addition of extracorporeal flow within the aorta offer an anatomically appropriate, physiologically similar robust model to simulate aortic endovascular procedures, with potential applications in interventional radiology training and medical device testing as a pre-clinical model.",

keywords = "Cadaveric perfusion, Endovascular aortic aneurysm repair (EVAR), Endovascular training",

author = "Helen McLeod and Cox, {Ben F.} and James Robertson and Robyn Duncan and Shona Matthew and Raj Bhat and Avril Barclay and J. Anwar and Tracey Wilkinson and Andreas Melzer and Houston, {J. Graeme}",

note = "Funding Information: This work was funded by Dr Hadwen Trust. The Dr Hadwen Trust (DHT) is the UK{\textquoteright}s leading non-animal biomedical research charity that exclusively funds and promotes human-relevant research that replaces the use of animal{\textquoteright}s while supporting the progress of medicine. This project has received funding from the European Union{\textquoteright}s Seventh Framework Programme for research, technological development and demonstration under Grant agreement no 324487. This work followed on from EU 7th Framework-funded IIIOS (FP7/2007-2013, under Grant agreement no 238802). The researchers are very grateful to Professor Sir Alfred Cuschieri for the use of equipment during this research. We would like to thank the people who made this work possible by the generous donation of their bodies to medical research and science. Publisher Copyright: {\textcopyright} 2017, The Author(s).",

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McLeod, H, Cox, BF, Robertson, J, Duncan, R, Matthew, S, Bhat, R, Barclay, A, Anwar, J, Wilkinson, T, Melzer, A & Houston, JG 2017, 'Human Thiel-Embalmed Cadaveric Aortic Model with Perfusion for Endovascular Intervention Training and Medical Device Evaluation', Cardiovascular and Interventional Radiology, vol. 40, no. 9, pp. 1454-1460. https://doi.org/10.1007/s00270-017-1643-z

TY - JOUR

T1 - Human Thiel-Embalmed Cadaveric Aortic Model with Perfusion for Endovascular Intervention Training and Medical Device Evaluation

AU - McLeod, Helen

AU - Cox, Ben F.

AU - Robertson, James

AU - Duncan, Robyn

AU - Matthew, Shona

AU - Bhat, Raj

AU - Barclay, Avril

AU - Anwar, J.

AU - Wilkinson, Tracey

AU - Melzer, Andreas

AU - Houston, J. Graeme

N1 - Funding Information: This work was funded by Dr Hadwen Trust. The Dr Hadwen Trust (DHT) is the UK’s leading non-animal biomedical research charity that exclusively funds and promotes human-relevant research that replaces the use of animal’s while supporting the progress of medicine. This project has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration under Grant agreement no 324487. This work followed on from EU 7th Framework-funded IIIOS (FP7/2007-2013, under Grant agreement no 238802). The researchers are very grateful to Professor Sir Alfred Cuschieri for the use of equipment during this research. We would like to thank the people who made this work possible by the generous donation of their bodies to medical research and science. Publisher Copyright: © 2017, The Author(s).

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Purpose: The purpose of this investigation was to evaluate human Thiel-embalmed cadavers with the addition of extracorporeal driven ante-grade pulsatile flow in the aorta as a model for simulation training in interventional techniques and endovascular device testing. Materials and Methods: Three human cadavers embalmed according to the method of Thiel were selected. Extracorporeal pulsatile ante-grade flow of 2.5 L per min was delivered directly into the aorta of the cadavers via a surgically placed connection. During perfusion, aortic pressure and temperature were recorded and optimized for physiologically similar parameters. Pre- and post-procedure CT imaging was conducted to plan and follow up thoracic and abdominal endovascular aortic repair as it would be in a clinical scenario. Thoracic endovascular aortic repair (TEVAR) and endovascular abdominal repair (EVAR) procedures were conducted in simulation of a clinical case, under fluoroscopic guidance with a multidisciplinary team present. Results: The Thiel cadaveric aortic perfusion model provided pulsatile ante-grade flow, with pressure and temperature, sufficient to conduct a realistic simulation of TEVAR and EVAR procedures. Fluoroscopic imaging provided guidance during the intervention. Pre- and post-procedure CT imaging facilitated planning and follow-up evaluation of the procedure. Conclusion: The human Thiel-embalmed cadavers with the addition of extracorporeal flow within the aorta offer an anatomically appropriate, physiologically similar robust model to simulate aortic endovascular procedures, with potential applications in interventional radiology training and medical device testing as a pre-clinical model.

AB - Purpose: The purpose of this investigation was to evaluate human Thiel-embalmed cadavers with the addition of extracorporeal driven ante-grade pulsatile flow in the aorta as a model for simulation training in interventional techniques and endovascular device testing. Materials and Methods: Three human cadavers embalmed according to the method of Thiel were selected. Extracorporeal pulsatile ante-grade flow of 2.5 L per min was delivered directly into the aorta of the cadavers via a surgically placed connection. During perfusion, aortic pressure and temperature were recorded and optimized for physiologically similar parameters. Pre- and post-procedure CT imaging was conducted to plan and follow up thoracic and abdominal endovascular aortic repair as it would be in a clinical scenario. Thoracic endovascular aortic repair (TEVAR) and endovascular abdominal repair (EVAR) procedures were conducted in simulation of a clinical case, under fluoroscopic guidance with a multidisciplinary team present. Results: The Thiel cadaveric aortic perfusion model provided pulsatile ante-grade flow, with pressure and temperature, sufficient to conduct a realistic simulation of TEVAR and EVAR procedures. Fluoroscopic imaging provided guidance during the intervention. Pre- and post-procedure CT imaging facilitated planning and follow-up evaluation of the procedure. Conclusion: The human Thiel-embalmed cadavers with the addition of extracorporeal flow within the aorta offer an anatomically appropriate, physiologically similar robust model to simulate aortic endovascular procedures, with potential applications in interventional radiology training and medical device testing as a pre-clinical model.

KW - Cadaveric perfusion

KW - Endovascular aortic aneurysm repair (EVAR)

KW - Endovascular training

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Human Thiel-Embalmed Cadaveric Aortic Model with Perfusion for Endovascular Intervention Training and Medical Device Evaluation

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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