Introduction: Carotid endarterectomy (CEA) is a common, well-developed, surgical procedure. While surgical simulation is gaining importance for residency training, CEA practice opportunities for surgical residents are limited. The aim of the study is to describe a new relevant tissue CEA training model.
Methods: Six bovine placentas were used to create the model. Each placenta provided about 6 large arterial and venous bifurcations. In total, 36 large vessel bifurcations were dissected and prepared for the CEA simulation. Bovine placenta vessels were arranged to simulate the common carotid artery (CCA), internal carotid artery (ICA), and external carotid artery (ECA). The diameter and wall thickness were measured and compared with human CCA, ICA, and ECA parameters.
Results: All bovine placentas provided vessels suitable for modeling carotid artery bifurcations and CEA training. Mean ± standard deviation diameters of simulated CCA, ECA, and ICA were 11.2 ± 1.8, 4.3 ± 0.5, and 9.8 ± 3.0 mm, respectively, from non-dilated veins, and 8.7 ± 1.4, 4.4 ± 1.3, and 7.2 ± 1.7 mm, respectively, from non-dilated arteries. Mean vessel wall thicknesses were 2.0 ± 0.6 mm for arteries and 1.4 ± 0.5 mm for veins. Placental vessel tissue had dimensions and handling characteristics similar to human carotid arteries. The CEA procedure and its subtasks, including vessel-tissue preparation and surgical skills performance, could be reproduced with high fidelity.
Conclusions: A bovine placenta training model for CEA is inexpensive, readily available, and closely resembles human carotid arteries. The model can provide a convenient, efficient and valuable simulation and practice addition for vascular surgery training.
Patient Care: Training carotid endarterectomy procedure on the presented model aimed to increase manual microsurgical skill proficiency and decrease technical-related complications during this operation.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of neurosurgical rehearsal for carotid endarterectomy procedure, 2) Create new tissue model for carotid endarterectomy surgery simulation using bovine placenta vessels.