Together with the Clinic and Polyclinic for Neuroradiological Diagnostics and Intervention of the University Hospital Eppendorf, the COSY-SMILE project is being worked on at the PKT, building on the results of the ELBE-NTM project.

Initial situation

Ischaemic stroke is one of the main factors leading to disability and death worldwide. The most common cause of acute stroke is an occlusion of a cerebral artery by a blood clot (thrombus), which leads to oxygen deprivation of a brain region and consequently to cerebral infarction. Reopening via a catheter-based treatment, the so-called thrombectomy, is the first-choice therapy. Under high time pressure, the goal is to open the affected vessel as quickly as possible. Patient-specific variables such as vessel curves and constrictions become challenges for the treating physician. Therefore, continuous training and confident control of thrombectomy techniques is indispensable for the physician. A common training model for thrombectomy is the animal model in pigs. Due to the clinical establishment of thrombectomy as a treatment procedure since 2015, a high demand for training measures is to be expected.

Objective

The COSY-SMILE project aims to develop a neurointerventional training and research model on which endovascular stroke treatment can be learned, practised and studied and further developed under standardised conditions. In addition, this model is to be used for the standardised assessment of doctors' neurointerventional skills. It replaces current animal experiments on mainly pigs for training purposes and is intended to reduce the number of animals used for scientific purposes in stroke research and training.

Approach

Based on the physical training model HANNES, the COSY-SMILE model will reproduce the entire range of vascular catheter access from the femoral artery to the large cerebral arteries for the training and research of thrombectomy. An animal blood-free substitute for thrombi is to be implemented. The modelling of the particularly challenging vascular anatomies with vascular constrictions (stenoses) and age-related loop formations will be based on original anonymised patient data. By using additive manufacturing, real cases can be simulated and practised on the model. The modular integration of several vessel variants in the model reproduces the most varied (patient-specific) manifestations of the disease. Furthermore, procedures for the standardised evaluation of the treatment success are developed and integrated into the model in the form of measurement technology. The COSY-SMILE model developed in the project is intended to completely replace the animal models currently used for training at the UKE.