Modelling stroke and heart disease in cadavers to replace pigs
Modelling clots using Thiel-embalmed cadavers
Thiel-embalming is a method that leaves cadavers with more life-like properties than those embalmed in the standard way. Emma helped develop a clot model that could be used in human Thiel-embalmed cadavers to provide a realistic model for stroke training.
Clots in patients can be captured and retrieved using devices passed through tiny incisions in blood vessels; however there are currently not enough doctors to perform this potentially life-saving technique. Pigs are often used for training as the size of their blood vessels are similar to humans. However, pigs and humans do not have the same anatomy.
This project could provide a superior training tool for doctors to treat stroke and heart attacks caused by blood clots, without the use of pigs.
The Science behind the Studentship
Development of Thrombus Model for Thiel cadaveric training model
Stroke and heart attack are a leading cause of death in the United Kingdom. In the UK, the outcome for patients suffering from heart attack has been revolutionised by endovascular intervention, techniques where special devices are passed through tiny incisions into blood vessels and using X-Ray, they are guided through the body to the clot, where they capture and retrieve it, returning blood flow to the tissue. Evidence shows that patient’s recovery is quicker, they have fewer health problems and have a shorter hospital stay after these treatments. Certain types of stroke could also be treated using this technique, however, currently there are not enough trained doctors to give this potentially life-saving technique to the population. By making our cadaveric model more realistic, we improve its potential use in training, and provide a superior human model than using animals which do not have the same anatomy to train on.
The use of animals to training in endovascular interventions is described regularly in literature, with the pig is the most commonly cited animal used as it has vessels of similar calibre to many human vessels (Dondelinger et al. 1998). The limitations of using animals, i.e. their differing anatomy is considered a trade off in terms of their realism, particularly in comparison to virtual models which are currently the most commonly used alternatives (Berry et al. 2007, Neequaye et al. 2007). Further cited benefits of animal models are the ability to simulate disease states increasing the realism of the simulation (Namba et al. 2013). By adopting the approach of simulating pathology we will provide further complexity to the Thiel cadaveric model, offering an anatomically accurate model with the complexity to simulate the human patient as a superior alternative to the use of animals in this context.
The successful completion of this study would result in a thrombus model, which will be used to deliver hands on endovascular training to doctors. Currently our group provide a number of hands on training courses for doctors, the development of the cadaveric thrombus model will allow us to develop a course dedicated to treating certain types of stroke’s . This area is currently very topical, advances in technology would allow the treatment of many more victims of stroke however there are insufficient numbers of trained doctors to facilitate this. Providing a realistic human cadaveric training model would potentially bridge this gap, reducing the need to use animals to achieve the goal of treating more patients suffering from stroke.
REFERENCES: Dondelinger RF et al., 1998. “Relevant Radiological Anatomy of the Pig as a Training Model in Interventional Radiology.” European Radiology 8 (7): 1254–73.; Berry M. et al., 2007. “Porcine Transfer Study: Virtual Reality Simulator Training Compared with Porcine Training in Endovascular Novices.” CardioVascular and Interventional Radiology 30 (3): 455–61.; Neequaye S.K. et al., 2007. “Endovascular Skills Training and Assessment.” Journal of Vascular Surgery 46 (5): 1055–64.; Namba, K.et al., 2013. “Swine Hybrid Aneurysm Model for Endovascular Surgery Training.” Interventional Neuroradiology 19 (2): 153–58.