{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T23:56:59Z","timestamp":1791590219038,"version":"4.3.4"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Intraoperative injury of the internal carotid artery (ICA) is the most dreaded complication in endoscopic endonasal surgery (EES) of skull base. Training for ICA injury is practically impossible in live operative settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To evaluate a pulsatile perfusion-based live cadaveric model for ICA injury simulation in a laboratory setting. The major emphasis of the study was to evaluate various means of controlling acute bleeding and evaluating the practical utility of this model for training purposes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Five embalmed, uninjected cadaveric heads were prepared for study by connecting to a pulsatile perfusion pump system filled with artificial blood solution. EES approaches were used to evaluate different types of ICA injuries similar to operative scenarios. Various methods of managing ICA injuries such as packing, clipping, and trapping, were evaluated. The educational advantages of the live cadaver model were assessed using questionnaires given to participants in a hands-on dissection course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The trainee was faced with several scenarios similar to those encountered during an actual intraoperative ICA injury. Packing, clipping, and trapping of the ICA injury were successfully achieved in all segments of the ICA. Clip-based reconstruction techniques were successfully developed. All trainees reported gaining new knowledge, learning new techniques. The responses to the questionnaire confirmed the significant educational value of this model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The live cadaver model presented here provides real-life experience with major vessel injury during EES in a laboratory setting. This model could significantly improve current training for the management of intraoperative vascular injuries during EES.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opx035","type":"journal-article","created":{"date-parts":[[2017,6,29]],"date-time":"2017-06-29T05:59:34Z","timestamp":1498715974000},"page":"732-738","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":51,"title":["\u201cLive Cadaver\u201d Model for Internal Carotid Artery Injury Simulation in Endoscopic Endonasal Skull Base Surgery"],"prefix":"10.1227","volume":"13","author":[{"given":"Paolo","family":"Pacca","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh School of Medi-cine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"},{"name":"Neurosurgical Unit, Department of Neurosciences, Uni-versity of Torino, Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukhdeep S","family":"Jhawar","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh School of Medi-cine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"},{"name":"Department of Neurosurgery, King Edward Memorial Hospital, Parel, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel V","family":"Seclen","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh School of Medi-cine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"},{"name":"Hospital de Alta Complejidad en Red el Cruce, Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Wang","sequence":"additional","affiliation":[{"name":"De-partment of Otolaryngology, Univer-sity of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Snyderman","sequence":"additional","affiliation":[{"name":"De-partment of Otolaryngology, Univer-sity of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh School of Medi-cine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad","family":"Aboud","sequence":"additional","affiliation":[{"name":"Arkansas Neuroscience Institute, St. Vincent Health System, Little Rock, Arkansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan C","family":"Fernandez-Miranda","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh School of Medi-cine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,12]]},"reference":[{"issue":"4","key":"bib1-20240909","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1097\/MLG.0b013e318031c817","article-title":"Acquisition of surgical skills for endonasal skull base surgery: a training program","volume":"117","author":"Snyderman","year":"2007","journal-title":"Laryngoscope"},{"issue":"3","key":"bib2-20240909","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1227\/NEU.0b013e31825ea3e0","article-title":"Endoscopic endonasal approach for resection of cranial base chordomas: outcomes and learning curve","volume":"71","author":"Koutourousiou","year":"2012","journal-title":"Neurosurgery"},{"issue":"1 suppl 1","key":"bib3-20240909","article-title":"The endoscopic transnasal transsphenoidal approach for the treatment of cranial base chordomas and chondrosarcomas","volume":"59","author":"Frank","year":"2006","journal-title":"Neurosurgery"},{"issue":"2 suppl operative","key":"bib4-20240909","article-title":"Carotid artery injury during endoscopic endonasal skull base surgery: incidence and outcomes","volume":"73","author":"Gardner","year":"2013","journal-title":"Neurosurgery"},{"issue":"3","key":"bib5-20240909","doi-asserted-by":"crossref","first-page":"153","DOI":"10.2500\/105065898781390154","article-title":"A protocol for management of a catastrophic complication of functional endoscopic sinus surgery: internal carotid artery injury","volume":"12","author":"Park","year":"1998","journal-title":"Am J Rhinol"},{"issue":"2","key":"bib6-20240909","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1055\/s-0031-1275255","article-title":"A vascular catastrophe during endonasal surgery: an endoscopic sheep model","volume":"21","author":"Valentine","year":"2011","journal-title":"Skull Base"},{"issue":"5-6","key":"bib7-20240909","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1055\/s-0030-1269927","article-title":"Animal model for endoscopic neurosurgical training: technical note","volume":"53","author":"Fernandez-Miranda","year":"2010","journal-title":"Minim Invasive Neurosurg"},{"issue":"2","key":"bib8-20240909","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1002\/alr.20033","article-title":"The efficacy of hemostatic techniques in the sheep model of carotid artery injury","volume":"1","author":"Valentine","year":"2011","journal-title":"Int Forum Allergy Rhinol"},{"issue":"1","key":"bib9-20240909","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1055\/s-0029-1246169","article-title":"Neuroendoscopic training: presentation of a new real simulator","volume":"53","author":"Zymberg","year":"2010","journal-title":"Minim Invasive Neurosurg"},{"issue":"6","key":"bib10-20240909","first-page":"1484","article-title":"Novel simulation for training trauma surgeons","volume":"71","author":"Aboud","year":"2011","journal-title":"J Trauma"},{"issue":"5","key":"bib11-20240909","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1067\/mva.2001.114214","article-title":"A human cadaveric circulation model","volume":"33","author":"Garrett","year":"2001","journal-title":"J Vasc Surg"},{"issue":"4","key":"bib12-20240909","first-page":"243","article-title":"Simulation of cerebrovascular circulation in the human cadaver for surgical neuroanatomy training","volume":"17","author":"G\u00fcven\u00e7er","year":"2007","journal-title":"Turk Neurosurg"},{"issue":"6","key":"bib13-20240909","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/j.surneu.2009.02.028","article-title":"Human cadaver brain infusion model for neurosurgical training","volume":"72","author":"Olabe","year":"2009","journal-title":"Surg Neurol"},{"issue":"6","key":"bib14-20240909","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.3171\/jns.2002.97.6.1367","article-title":"New laboratory model for neurosurgical training that simulates live surgery","volume":"97","author":"Aboud","year":"2002","journal-title":"J Neurosurg"},{"issue":"5","key":"bib15-20240909","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.3171\/2014.12.JNS141551","article-title":"\"Live cadavers\" for training in the management of intraoperative aneurysmal rupture","volume":"123","author":"Aboud","year":"2015","journal-title":"J Neurosurgy"},{"issue":"5","key":"bib16-20240909","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1055\/s-0034-1372470","article-title":"A perfusion-based human cadaveric model for management of carotid artery injury during endoscopic endonasal skull base surgery","volume":"75","author":"Pham","year":"2014","journal-title":"J Neurol Surg B Skull Base"},{"issue":"3","key":"bib17-20240909","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1002\/lary.21361","article-title":"Controlling the surgical field during a large endoscopic vascular injury","volume":"121","author":"Valentine","year":"2011","journal-title":"Laryngoscope"},{"issue":"3","key":"bib18-20240909","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1227\/01.NEU.0000154697.75300.C2","article-title":"Analysis of intraoperative rupture in the surgical treatment of 1694 saccular aneurysms","volume":"56","author":"Leipzig","year":"2005","journal-title":"Neurosurgery"},{"issue":"5","key":"bib19-20240909","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1016\/j.wneu.2015.06.032","article-title":"Endoscopic endonasal clipping of intracranial aneurysms: surgical technique","volume":"84","author":"Gardner","year":"2015","journal-title":"World Neurosurgery"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/13\/6\/732\/30213292\/opx035.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/01787389-201712000-00011","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:50:24Z","timestamp":1786121424000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01787389-201712000-00011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,29]]},"references-count":19,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opx035","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6,29]]},"assertion":[{"value":"2016-07-04","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-06-14","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}