Transcarotid artery revascularization simulation using 3D printing and polymers

Background: Phantoms are often used to train new surgical technologies.Unfortunately, these products are expensive and typically have simplified anatomy, limiting access, and provide suboptimal training.This is a report of an in-house simulation using 3D printing and multilayer polymer hydrogels to train attending physicians on a new carotid stenting technology.Methods: TransCarotid Artery Revascularization (TCAR) is a novel procedure from Silk Road Medical for carotid stenting.To safely learn how to use this device, two attending surgeons performed a proctored simulation using a realistic, pulsatile, and bleeding human neck model.The simulation was created by 3D printing injection molds and casting anatomically correct polymer components.The following day, the TCAR procedure was performed on an 81year-old man with symptomatic right carotid stenosis.Results: The TCAR procedure was successfully performed in the simulation model and in the live patient.The surgeons reported that the simulation allowed them to learn the procedure under risk-free but realistic operative conditions.The patient did not have any immediate or long-term adverse events.Conclusions: Replicating human anatomy using 3D printing and multilayer polymer hydrogels provides a cost-effective opportunity to practice using novel surgical technologies before attempting live cases.