Abstract
<title>Abstract</title> <p>Introduction: Simulation-based education (SBE) for endovascular aortic repair (EVAR) is typically delivered in simulation centres and workshops using standardised aortic anatomy. A logical next step is patient-specific rehearsal (PSR), in which the planned EVAR is rehearsed using the individual patient’s anatomy and the planned EVAR device. This exploratory study aims to explore PSR realism and its impact on procedural planning and operator preparedness for standard EVAR. Methods Standard EVAR procedures were scheduled for PSR. The aortic anatomy was segmented from each patient’s CT scan, and a virtual patient was uploaded into the simulator. The primary operator practised the PSR scenario immediately before the real EVAR case. Time spent creating the virtual patient and for the PSR scenarios was recorded. Operator preparedness was assessed with the cognitive appraisal ratio (CAR) before and after the PSR. Results Ten EVAR procedures were included during the study period. The median time to create the PSR scenarios was 24 (IQR:22–29) minutes. It was possible to complete 9 of the 10 PSR scenarios; one case could not be created due to poor imaging quality. Operators spent a median of 32 (IQR: 28–34) minutes to practice the case. 89% of the operators rated the simulations as realistic, and 89% reported that the PSR improved their confidence level, which was confirmed by a median reduction in CAR of 0.6 (IQR: 0.3–0.7) (p=.008). Conclusions PSR in EVAR is well received by the primary operator and has the potential to improve preparedness for real procedures. PSR in EVAR is feasible to implement in everyday clinical practice and in randomised controlled trials investigating peri- and postoperative outcomes.</p>