{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:12:53Z","timestamp":1788415973522,"version":"build-2803163510"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Simulation-based training in endovascular procedures remains limited by the availability of biological vascular models that provide tactile feedback. Existing animal, cadaveric, synthetic, and virtual simulators incompletely reproduce the mechanical behavior of complex neurovascular anatomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Human placentas were prepared by cannulation of the umbilical vessels, vascular flushing, and establishment of continuous gravity-driven flow. Vessel curvature was modified to simulate challenging neurovascular anatomy, including carotid siphon\u2014like configurations, and aneurysm analogues were created. Controlled vessel perforations were performed to simulate emergent hemostatic scenarios. Endovascular procedures included liquid embolization with ethylene\u2014vinyl alcohol copolymer (EVOH) and n-butyl cyanoacrylate (NBCA), coil embolization, flow-diverting stent deployment, and endovascular retrieval techniques. All procedures were performed under angiographic guidance with continuous flow.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The placenta model provided reliable angiographic visualization and tactile feedback. Liquid embolization demonstrated procedural behaviors including reflux, plug formation, distal penetration, and effective hemostasis. Stent deployment produced vessel straightening with subsequent elastic recoil. Thrombus and device retrieval simulations demonstrated vessel deformation with recovery after device removal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The human placenta represents an ethically favorable biological platform for endovascular training. This model enables simulation of a broad range of neurointerventional and vascular procedures while reducing reliance on animal models.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1856017","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:17:11Z","timestamp":1788412631000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Human placenta as a biological vascular model for endovascular training"],"prefix":"10.3389","volume":"17","author":[{"given":"Z.","family":"Itsekzon-Hayosh","sequence":"first","affiliation":[{"name":"Joint Department of Medical Imaging, University Health Network","place":["Toronto, ON, Canada"]},{"name":"Department of Medical Imaging, Divisions of Neuroradiology and Vascular and Interventional Radiology, University of Toronto","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Chung","sequence":"additional","affiliation":[{"name":"Joint Department of Medical Imaging, University Health Network","place":["Toronto, ON, Canada"]},{"name":"Department of Medical Imaging, Divisions of Neuroradiology and Vascular and Interventional Radiology, University of Toronto","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Warren","sequence":"additional","affiliation":[{"name":"Joint Department of Medical Imaging, University Health Network","place":["Toronto, ON, Canada"]},{"name":"Department of Medical Imaging, Divisions of Neuroradiology and Vascular and Interventional Radiology, University of Toronto","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Agid","sequence":"additional","affiliation":[{"name":"Joint Department of Medical Imaging, University Health Network","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Helmi","sequence":"additional","affiliation":[{"name":"Joint Department of Medical Imaging, University Health Network","place":["Toronto, ON, Canada"]},{"name":"Department of Medical Imaging, Divisions of Neuroradiology and Vascular and Interventional Radiology, University of Toronto","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. C.","family":"Mafeld","sequence":"additional","affiliation":[{"name":"Joint Department of Medical Imaging, University Health Network","place":["Toronto, ON, Canada"]},{"name":"Department of Medical Imaging, Divisions of Neuroradiology and Vascular and Interventional Radiology, University of Toronto","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. R.","family":"Mosimann","sequence":"additional","affiliation":[{"name":"Joint Department of Medical Imaging, University Health Network","place":["Toronto, ON, Canada"]},{"name":"Department of Medical Imaging, Divisions of Neuroradiology and Vascular and Interventional Radiology, University of Toronto","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1177\/1591019918810850","article-title":"Surgical options in experimental porcine models for endovascular training in complex vascular lesions","volume":"25","author":"Arikan","year":"2019","journal-title":"Interv Neuroradiol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1016\/j.avsg.2017.01.024","article-title":"Design of a pulsatile fresh frozen human cadaver circulation model for endovascular training","volume":"44","author":"Nesbitt","year":"2017","journal-title":"Ann Vasc Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1016\/j.jss.2022.05.009","article-title":"A systematic review of simulation-based training in vascular surgery","volume":"279","author":"Haiser","year":"2022","journal-title":"J Surg Res"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1136\/neurintsurg-2013-010813","article-title":"Human placenta as an ex vivo vascular model for neurointerventional research","volume":"6","author":"Kwok","year":"2014","journal-title":"J Neurointerv Surg."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.3171\/2015.1.JNS141583","article-title":"Face, content, and construct validity of human placenta as a haptic training tool in neurointerventional surgery","volume":"124","author":"Ribeiro de Oliveira","year":"2016","journal-title":"J Neurosurg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1136\/neurintsurg-2017-013474","article-title":"Assessment of human placenta as an ex vivo vascular model for testing liquid embolic agent injections","volume":"10","author":"Okada","year":"2018","journal-title":"J Neurointerv Surg"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"925763","DOI":"10.3389\/fneur.2022.925763","article-title":"The human placenta as a model for training and research in mechanical thrombectomy","volume":"13","author":"Burel","year":"2022","journal-title":"Front Neurol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.wneu.2020.07.116","article-title":"Novel simulation model with pulsatile flow system for microvascular training, research, and improving patient surgical outcomes","volume":"143","author":"Gallardo","year":"2020","journal-title":"World Neurosurg"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/j.wneu.2023.08.118","article-title":"Two-stage pulsatile human placenta model for microvascular anastomosis training in neurosurgery","volume":"179","author":"Ceccato","year":"2023","journal-title":"World Neurosurg"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e115","DOI":"10.1016\/j.wneu.2020.12.177","article-title":"Stroke microsurgical thrombectomy human placenta simulator","volume":"148","author":"de Oliveira","year":"2021","journal-title":"World Neurosurg"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e471","DOI":"10.1016\/j.wneu.2023.11.123","article-title":"Topographical systematization of human placenta model for training in microneurosurgery","volume":"182","author":"Apaza-Tintaya","year":"2024","journal-title":"World Neurosurg"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1227\/ons.0000000000001190","article-title":"A comprehensive training model for simulation of intracranial aneurysm surgery using a human placenta and a cadaveric head","volume":"27","author":"De Schlichting","year":"2024","journal-title":"Oper Neurosurg"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1227\/ons.0000000000001305","article-title":"Model of arteriovenous malformation created in human placenta for training in vascular microneurosurgery","volume":"28","author":"Canache Jim\u00e9nez","year":"2025","journal-title":"Oper Neurosurg."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.jmbbm.2017.05.023","article-title":"Polymerization kinetics of a lipiodol\u2014Glubran 2 cyanoacrylate mixture","volume":"74","author":"Li","year":"2017","journal-title":"J Mech Behav Biomed Mater"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1016\/j.diii.2014.11.030","article-title":"Ethylene vinyl alcohol copolymer (Onyx\u00ae) in peripheral interventional radiology: indications, advantages and limitations","volume":"96","author":"Kilani","year":"2015","journal-title":"Diagn Interv Imaging"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1136\/neurintsurg-2021-017279","article-title":"Bailout stentectomy of 47 self-expandable intracranial stents","volume":"14","author":"Chapot","year":"2022","journal-title":"J Neurointerv Surg"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1996","DOI":"10.3174\/ajnr.A3552","article-title":"Stent retriever use for retrieval of displaced microcoils: a consecutive case series","volume":"34","author":"Leslie-Mazwi","year":"2013","journal-title":"AJNR Am J Neuroradiol"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1856017\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:17:11Z","timestamp":1788412631000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1856017\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":17,"alternative-id":["10.3389\/fneur.2026.1856017"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1856017","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"article-number":"1856017"}}