December 13, 2012
The Simbionix PROcedure™ Rehearsal Studio (PRS) was put to the test when
Barry T. Katzen
, MD, FACR, FACC, FSIR, Founder/ Medical Director of Baptist Cardiac and Vascular Institute utilized the technology to pre-operatively plan and rehearse for a Live Case he performed at the 2012 TCT Conference. Following the rehearsal done in advance of the surgery, Dr. Katzen performed the EVAR endovascular intervention live at the TCT. This "Future Techniques for Endovascular Therapy" session demonstrated new techniques for possible improvements on a variety of procedures in the endovascular space.
The practice session involved the pre-operative review of the patient's anatomy, selection of tools dedicated for EVAR procedure, including deploying a Gore C3 Excluder endoprosthesis .The patient had challenging anatomy with a lot of iliactortuosity and a fairly big flow lumen which posed technical challenges for the group of physicians doing this procedure.
The patient's CT scan was downloaded into the PRS which allowed Dr. Katzen to create a patient-specific 3D virtual anatomical model. Dr. Katzen used it to plan and practice the endovascular intervention which included the identification of the appropriate access strategy, selection of tools, guide wires, catheters, endoprosthesis as well as choosing the effective fluoroscopic views.
At TCT, Dr. Katzen showed the practice video and then performed the actual surgery on the patient they had rehearsed earlier. The live case replicated the rehearsal.
"The patient presented several anatomic challenges that were realistically demonstrated in the simulator," said Dr. Katzen.
"As a result of the PRS simulation, we reevaluated our measurements and modified the right side of the limb. We verified, went back and recalculated everything and basically adjusted the right limb size. We felt that it was going to work and it did," said Dr. Katzen. "The simulation has predicted type Ib endoleak in the right limb which we actually corrected with a balloon and didn't have to put in another graft."