Simulation-based endovascular skills assessment: The future of credentialing?

Abstract

Structured endovascular skills assessment correlates well with prior procedural experience within a high-fidelity simulation environment. In addition to improving endovascular training, simulators may prove useful in determining procedural competency and credentialing standards for endovascular surgeons.

Untitled

“…17 Similarly, the SYNTAX trial has reported an incremental risk for death, cardiac death and myocardial infarction between fi rst and third year of follow-up among patients receiving a DES, which was signifi cant among patients with three-vessel disease. Th e SYN-TAX trial also reported a 7.4% rate of stent thrombosis at three years, 19 and the ARTS II study reported a 9% rate of defi nite, probable, or possible stent thrombosis over fi ve years, 20 each of which is higher than the 6.2% rate of stent thrombosis over fi ve years among DES treated patients in this study. Patients in our study who received a DES had a signifi cantly lower rate of repeat revascularization over fi ve years than patients who received a BMS.…”

“…However, the increased rate of death/MI beyond one year observed in ERACI III is accorded with other studies with similar DES designs in complex lesion subsets. 17,19,23 In agreement, at 3 years of follow up, in SYNTAX trial, DES patients treated with Taxus stents compared to CABG patients had significant higher incidence of cardiac events including raise of cardiac death and MI, and these findings were not observed at the first year of follow up. 5 Furthermore, in SYNTAX the subgroup of patients with three vessels disease, incidence of death, MI and the composite of death/MI/stroke were also significantly higher in the PCI group.…”

“…During late outcome, some randomized studies have also reported an increased incidence of hard cardiac events aft er one year of follow-up among patients who received a fi rst generation of DES designs. [16][17][18][19] Pooled data from the SIRIUS trials showed a higher rate of hard cardiac events beyond one year among patients with diabetes receiving DES compared with patients with diabetes who received a BMS, despite a lower rate of restenosis. 17 Similarly, the SYNTAX trial has reported an incremental risk for death, cardiac death and myocardial infarction between fi rst and third year of follow-up among patients receiving a DES, which was signifi cant among patients with three-vessel disease.…”

Using simulation for interventional radiology training

“…The British Journal of Radiology, July 2010assessments in an endovascular simulation, using an observer-based global rating scale [32]; at the same time, there was no demonstrable construct validity for the simulation's inbuilt, objective, automated metrics. Hence, there is a pressing need to develop valid, evidence-based metrics for objective assessment of known CPS in IR simulations; this key, but unrealised, strength of virtual simulations is a fertile area for ongoing investigation [33].…”

SCAI/AATS/ACC/STS operator and institutional requirements for transcatheter valve repair and replacement. Part II. Mitral valve

“…Minimum training for specific procedures and devices will, for the immediate future, be primarily dictated by FDA approval requirements. Simulation should play a significant role in technical training and proficiency maintenance for these evolving procedures [14][15][16][17][18]. As the procedures become integrated into mainstream care delivery, the strategy for training will likely need to be revised.…”