This study aimed to determine the effect of simulation training using a 3-dimensionally (3D) printed patient-specific vascular model on the advanced vascular catheterization skills of experienced interventional radiologists. Two specific anatomical types of 3D-printed patient-specific models from 2 patients with challenging celiac axis arterial anatomy were constructed. The Global Rating Scale of Endovascular Performance (GRS-EP) was used to evaluate vascular insertion skills. The training sessions comprised pretraining and posttraining evaluations. Two blinded raters evaluated the effectiveness of the training. Improvements were observed in success rate, insertion time, and GRS-EP scores among all 5 experienced interventonial radiologists. The GRS-EP demonstrated high interrater reliability. Posttraining scores increased significantly in both video and self-evaluations. Although there is no proof that better performance on this type of model directly translates to improved performance in humans, simulation training using this model has the potential to help experienced interventional radiologists further refine their vascular catheterization skills.

Purpose: To develop a vascular intervention simulation model that replicates the characteristics of a human patient and to compare the mechanical properties of a 3-dimensional (3D)-printed transparent flexible resin with those of porcine arteries using the elastic modulus (E) and kinetic friction coefficient (mu k).Materials and Methods: Resin plates were created from a transparent flexible resin using a 3D printer. Porcine artery plates were prepared by excising the aorta. E values and the adhesive strengths of the resin and arterial surfaces toward a polyethylene plate, were measured with a tensile-compressive mechanical tester. Resin transparency was measured using an ultraviolet-visible light spectrometer. The mu k value of the resin plate surface after applying silicone spray for 1-5 seconds and that of the artery were measured using a translational friction tester.Results: E values differed significantly between the arteries and resin plates at each curing time (0.20 MPa +/- 0.04 vs 8.53 MPa +/- 2.37 for a curing time of 1 minute; P < .05). The resin was stiffer than the arteries, regardless of the curing times. The visible light transmittance and adhesive strength of the resin decreased as the curing time increased. The adhesive strength of the artery was the lowest. The mu k value of the silicone-coated resin surface created by applying silicone for 2-3 seconds (thickness of the silicone layer, 1.6-2.0 mu m) was comparable with that of the artery, indicating that the coating imparted a similar slippage to the resin as to the living artery.Conclusions: A transparent flexible resin is useful for creating a transparent and slippery vascular model for vascular intervention simulation.

The development of three-dimensional printers has facilitated the creation of patient-specific hollow vessel models. Preoperative simulations using these types of models have improved our ability to select appropriate devices and embolic materials before performing complex endovascular procedures. This report describes 2 cases of high-flow renal arteriovenous fistulas (r-AVFs) that were successfully treated via short-segment embolization using the preloading coil-in-plug (p-CIP) technique. To our knowledge, this is the first report of r-AVF being treated using the p-CIP technique. Our findings demonstrate that preoperative simulation has the potential to improve the safety and reliability of complex vascular embolization procedures.