Desenvolvimento de simulador para Cateterização Endovascular de Carótidas / Development of a simulator for Endovascular Carotid Catheterization
DOI:
https://doi.org/10.34117/bjdv8n7-042Keywords:
cirurgia, Endovascular, treinamento, Cateterização, Carótidas, simulação, realística.Abstract
INTRODUÇÃO: A cirurgia endovascular surgiu como um grande ramo da cirurgia vascular buscando diminuir tempos cirúrgicos e reduzir morbimortalidades que são sempre elevados nas intervenções vasculares convencionais. Um dos ramos que cresce de forma exponencial é o tratamento de doenças ateroscleróticas extracranianas através das trombectomias nos acidentes vasculares cerebrais (AVC) em janela terapêutica e nas angioplastias das estenoses carotídeas. Logo, os cirurgiões precisam de um treinamento eficaz em tais procedimentos. No entanto, o Brasil ainda não dispõe de simuladores acessíveis e realísticos para possibilitar o treinamento. OBJETIVO: O presente trabalho teve por objetivo o desenvolvimento de um simulador para cateterização endovascular de artérias carótidas. METODOLOGIA: A concepção e construção do simulador teve início com a criação de um modelo anatômico em acrílico que simulasse a anatomia real da aorta ascendente e arco aórtico com seus ramos (artérias carótidas e subclávias). Após a criação do arcabouço inicial, foram feitos vários testes até conseguirmos um fluxo e uma frequência adequadas no bombeamento de líquido (água) por bomba pressórica para simular o fluxo sanguíneo e a resistência encontrada pelo fluxo de sangue quando o procedimento é realizado “in vivo”. CONCLUSÃO: O simulador de cateterização endovascular de artérias carótidas apresenta uma boa realidade para o treinamento dos profissionais que atuam na área. Consegue-se simular de forma realística as manobras de formatação de cateteres no arco aórtico, a realização de técnicas de imagens como a subtração digital, o “road map”, tudo isso feito em setor de hemodinâmica com a utilização de radiação e contraste reais
References
AGGARWAL, R. et al. Virtual Reality Simulation Training can Improve Inexperienced Surgeons’ Endovascular Skills. European Journal of Vascular and Endovascular Surgery, , [S. l.], p. 588-593, 6 jun. 2006
AGGARWAL, Shivani et al. Simulation in cardiac catheterization laboratory: Need of the hour to improve the clinical skills. Annals of Cardiac Anaesthesia, [S. l.], v. 19, n. 3, p. 521-526, 2016.
ANTAS, Jéssika da Silva et al. Curva de aprendizado de anastomose arteriovenosa com uso de simulador de baixo custo. Jornal Vascular Brasileiro, [S. l.], p. 1-10, 1 jun. 2020.
BADASH, I. et al. Innovations in surgery simulation: A review of past, current and future techniques. Annals of Translational Medicine, v. 4, n. 23, p. 1–10, 2016.
BEJOT Y, Benatru I, Rouaud P et al. Epidemiology of stroke in Europe: Geographic and environmental difference. J Neurol Sci 2007;262(1-2):85-8.
BENSENOR I, Goulart AC, Szwarcwald SL. Prevalência de acidente vascular cerebral e de incapacidade associada no Brasil: Pesquisa Nacional de Saúde – 2013. Arq NeuroPsiqui 2015;73(9):1-5.
BHATT, Deepak L. et al. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. Jama, v. 295, n. 2, p. 180-189, 2006.
BONOW, Robert O. et al. Braunwald's heart disease e-book: A textbook of cardiovascular medicine. Elsevier Health Sciences, 2011.
BLOCK, Peter C.; FALLON, John T.; ELMER, David. Experimental angioplasty: lessons from the laboratory. American Journal of Roentgenology, v. 135, n. 5, p. 907-912, 1980.
CASTANEDA-ZUNIGA, Wilfrido R. et al. Mechanics of angioplasty: an experimental approach. Radiographics, v. 1, n. 3, p. 1-14, 1981.
CHIUVE, Stephanie E. et al. Healthy lifestyle factors in the primary prevention of coronary heart disease among men: benefits among users and nonusers of lipid-lowering and antihypertensive medications. Circulation, v. 114, n. 2, p. 160-167, 2006.
COMPUTER simulation as a component of catheter based training. Journal of Vascular Surgery, [S. l.], p. 1112-1118, 3 jun. 2004.
GOLLEDGE, J. Davies AH. The symptomatic carotid plaque. Stroke, v. 30, p. 774-781, 2000.
CYBULSKY, Myron I.; WON, Doyon; HAIDARI, Mehran. Leukocyte recruitment to atherosclerotic lesions. The Canadian journal of cardiology, v. 20, p. 24B-28B, 2004.
DAROSA, Debra A; DUNNINGTON, Gary L; BELL JR, Richard H. Residency program models, implications, and evaluation: Results of a think tank consortium on resident work hours. Department of Surgery, [s. l.], p. 13-23, 1 jan. 2003. DOI 10.1067/msy.2003.67.
Desenvolvimento de simulador de cavidade torácica para o ensino de habilidades práticas em cirurgia torácica minimamente invasiva, Mestrado Profissional em Tecnologia Minimamente Invasiva do Centro Universitário Christus, FRANCISCO MARTINS NETO,2020
DOTTER, CHARLES T. Motion in cardiovascular radiography. Circulation, v. 12, n. 6, p. 1034-1042, 1955.
DOTTER, Charles T.; JUDKINS, Melvin P. Transluminal treatment of arteriosclerotic obstruction: description of a new technic and a preliminary report of its application. Circulation, v. 30, n. 5, p. 654-670, 1964.
DOTTER, C. T.; RÖSCH, J.; JUDKINS, M. P. Transluminal dilatation of atherosclerotic stenosis. Surgery, gynecology & obstetrics, v. 127, n. 4, p. 794-804, 1968.
DUSCHEK, Nikolaus et al. Simulator training on pulsatile vascular models significantly improves surgical skills and the quality of carotid patch plasty. Journal of Vascular Surgery, [S. l.], p. 1148-1154, 19 ago. 2012.
Fisher CM, Karnes WE. Local embolism. J Neuropathol Experim Neurol 1965;24:174.
FREISCHLAG, J. et al. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. New England journal of medicine, v. 325, n. 7, p. 445-453, 1991.
FOSTER, John H. Arteriography: cornerstone of vascular surgery. Archives of Surgery, v. 109, n. 5, p. 605-611, 1974.
GRÜNTZIG, A.; HOPFF, H. Perkutane Rekanalisation chronischer arterieller Verschlüsse mit einem neuen Dilatationskatheter. DMW-Deutsche Medizinische Wochenschrift, v. 99, n. 49, p. 2502-2505, 1974.
GREGG, Edward W. et al. Secular trends in cardiovascular disease risk factors according to body mass index in US adults. Jama, v. 293, n. 15, p. 1868-1874, 2005.
GOLLEDGE, J. Davies AH. The symptomatic carotid plaque. Stroke, v. 30, p. 774-781, 2000.
HOLLANDER M, Bots ML, Del Sol AI et al. Carotid plaques increase the risk of stroke and subtypes of cerebral infarction in asymptomatic elderly: the Rotterdam study. Circulation 2002;105(24):2872-7.
HILL, George James. Thomas Alva Edison. Health, medicine, and the great inventor. New Jersey medicine: the journal of the Medical Society of New Jersey, v. 100, n. 3, p. 19-21, 2003.
IVAR SELDINGER, Sven. Catheter replacement of the needle in percutaneous arteriography: a new technique. Acta radiologica, v. 49, n. sup434, p. 47-52, 2008.
KRUTH, Howard S. Sequestration of aggregated low-density lipoproteins by macrophages. Current opinion in lipidology, v. 13, n. 5, p. 483-488, 2002.
WILLIAMS, Kevin Jon; TABAS, Ira. Lipoprotein retention—and clues for atheroma regression. 2005.
LEE, K.W.M. et al. Evidence for Endovascular Simulation Training: A Systematic Review. European Journal of Vascular and Endovascular Surgery, [S. l.], v. 51, p. 441-451, 2016.
LIGON, B. Lee. Biography: history of developments in imaging techniques: Egas Moniz and angiography. In: Seminars in pediatric infectious diseases. WB Saunders, 2003. p. 173-181.
MAFFEI, F. H. A. Doenças vasculares periféricas 4a ed. Rio de Janeiro: Editora Guanabara Koogan, 2008, cap. 97- página 2001
MONIZ, EGAS. Contribution of the Portuguese School to the Future of Neurosurgery. Medicina contemporanea (Lisbon, Portugal), v. 68, n. 9, p. 463-473, 1950.
OSBORN, AG. Diagnostic Neuroradiology. Washington: Mosby; 1994. p. 18-32.
OHDE LE, Lee RT. Pathophysiology of atherosclerotic plaque development and rupture: an overview. Sem Vasc Med 2003;3(4):347-54.
PATEL, Amar D. et al. Learning Curves and Reliability Measures for Virtual Reality Simulation in the Performance Assessment of Carotid Angiography. Journal of the American College of Cardiology, [S. l.], v. 47, n. 9, p. 1796–1802, 2 maio 2006.
Peixoto, CCS, Brito,CJ. Cirurgía Endovascular e Angiologia. Rio de Janeiro: Revinter; 200. p. 396-416.
QUADER, Mohammed A.; SAWMILLER, Carol J.; SUMPIO, Bauer E. Radio contrast agents: history and evolution. In: Textbook of angiology. Springer, New York, NY, 2000. p. 775-783.
RUTHERFORD, RB. Vascular Surgery. Colorado: Saunders; 1989. p. 25-36.
RIZZOLI, R. WILHELM CONRAD ROENTGEN AND THE DISCOVERY OF X-RAYS. Annali di radiologia diagnostica, v. 37, p. 1-25, 1964.
SABA, Luca; MALLARINI, Giorgio. Comparison between quantification methods of carotid artery stenosis and computed tomographic angiography. Journal of computer assisted tomography, v. 34, n. 3, p. 421-430, 2010.
SCOTT, D. J. et al. Laparoscopic training on Bench Models: Better and More COst effective than Operating Room Experience. J Am Coll Surg, v. 7515, n. 00, p. 272–283, 2000.
SCOTT, D. J.; DUNNINGTON, G. L. The new ACS/APDS skills curriculum: Moving the learning curve out of the operating room. Journal of Gastrointestinal Surgery, v. 12, n. 2, p. 213–221, 2008.
SHIMIZU, Koichi; MITCHELL, Richard N.; LIBBY, Peter. Inflammation and cellular immune responses in abdominal aortic aneurysms. Arteriosclerosis, thrombosis, and vascular biology, v. 26, n. 5, p. 987-994, 2006.
SINGH, Niten; ROWE, Vincent Lopez. Atherosclerotic Disease of the Carotid Artery. Medscape. Acesso em, v. 25, 2012.
SOUZA, João Renato Figueiredo et al. Endovascular technique simulator for Neuroradiology learning. Arquivos de Neuro-Psiquiatria, [S. l.], p. 535-540, 29 jun. 2020.
STORK S, van den Beld AW, von Schacky C et al. Carotid artery plaque burden, stiffness, and mortality risk in elderly men: a prospective, population-based cohort study. Circulation 2004;110(3):344-8.
TRUELSEN T, Begg S, Mathers C. The global burden of cerebrovascular disease. World Health Organization, 2000.
TORVIK, A.; SVINDLAND, A.; LINDBOE, C. F. Pathogenesis of carotid thrombosis. Stroke, v. 20, n. 11, p. 1477-1483, 1989.
WARDLAW JM, Chappell FM, Stevenson M et al. Accurate, practical and cost-effective assessment of carotid stenosis in the UK. Health Tech Assess 2006;10(30):iii-iv, ix-x, 1-182.
WOLFE CD. The impact of stroke. Br Med Bull 2000;56(2):275-86.
WOLF, Gerald L.; LEVEEN, Robert F.; RING, Ernest J. Potential mechanisms of angioplasty. Cardiovascular and interventional radiology, v. 7, n. 1, p. 11-17, 1984.
YAN TAN, Shaun Shi; SARKER, Sudip K. Simulation in surgery: a review. Scottish Medical Journal, [S. l.], p. 104-109, 11 jun. 2011.
YANAGAWA, Bobby et al. See one, simulate many, do one, teach one: cardiac surgical simulation. Current Opinio Cardiology, [S. l.], v. 34, n. 5, p. 571-577, 10 set. 2019.
YUSUF, Salim et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. The lancet, v. 364, n. 9438, p. 937-952, 2004.
