The Vascular Simulations Replicator (patent #9,183,763 B2) duplicates the cardiac cycle with a functional left atrium and ventricle with mechanical mitral and aortic valves. The “blood flow” then passes through a silicone aorta with a compliance that recreates the clinical Windkessel effect resulting in pressure waveforms in the aorta of the replicator that are indistinguishable from the waveforms of a human aorta. The great vessels arising from the aortic arch and the cerebrovasculature can be prototyped from imaging studies of actual patients and their entire vascular anatomy and pathology can be recreated with silicone. Currently, any intracranial aneurysm can be recreated. Additional modules under development include intracranial occlusion to mimic acute stroke, carotid stenosis, intracranial arteriovenous malformations, abdominal aortic aneurysms and aortic and mitral stenosis.
A proprietary clear blood analog with a viscosity matching that of human blood duplicates the friction coefficients of endovascular devices, wires, and catheters as they traverse the vascular system.The blood analog fluid is automatically warmed up to body temperature(98.6 °F) by the Replicator. In addition, the cerebrovasculature is housed in a polyurethane “head” filled with a gel that mimics the compliance of the brain parenchyma. As a result, the passage of wires and catheters into the cerebrovasculature mimics the straightening of vessels as visualized clinically.The Replicator comes with a Windows laptop with a pre-installed software application that operates the Replicator via Bluetooth connectivity. Software functions include filling, running, and draining the Replicator, as well as controls to change the heart rate and mean blood flow rates to the Head and Body. The plots below show the flow waveforms recorded on the Replicator at different arterial sites.
The whole system can be placed in any fluoroscopic environment and imaging can be performed in any machine including biplane angiography systems. Standard fluoroscopy, roadmap imaging, digital subtraction angiography and rotational angiography can be performed with any contrast agent and acquisition sequences identical to real clinical cases can be obtained. “Artificial kidney” systems to remove contrast from the circulatory system are under development.
Unlike virtual simulators which are essentially glorified video games, the Vascular Simulations Replicator provides a realistic experience when performing endovascular procedures. The user interface is the angiographic environment in combination with any endovascular access product or device utilized to perform an actual clinical case. In addition, custom silicone vessels that duplicate the actual anatomy and pathology can be manufactured. For the first time, interventionalists will be able to practice a procedure with the identical vascular pathology they will ultimately treat clinically.
Our cerebrovascular flow loop consists of a plexiglass box which fits all of our intracranial vessels. Included in the unit are: one fluid storage container, one hemostasis valve Y-connector with touhy-borst adapter, and one perastaltic pump. This is a compact, easy-to-use setup for training and device evaluation with our
* Circle of Willis model shown in the image is sold separately