Journal of Surgical Simulation 2022; 9: 145 - 149

Published: 16 January 2023


Original article

Transcarotid artery revascularization simulation using 3D printing and polymers

Gabrielle Santangelo, Doran Mix, Michael Stoner and Jonathan J. Stone
Corresponding author: Jonathan J. Stone, University of Rochester Medical Center, Strong Memorial Hospital, Department of Neurosurgery, 601 Elmwood Avenue, Rochester, NY 14642, USA. Email:


Background: Phantoms are often used to train new surgical technologies. Unfortunately, these products are expensive and typically have simplified anatomy, limiting access, and provide suboptimal training. This is a report of an in-house simulation using 3D printing and multilayer polymer hydrogels to train attending physicians on a new carotid stenting technology.

Methods: TransCarotid Artery Revascularization (TCAR) is a novel procedure from Silk Road Medical for carotid stenting. To safely learn how to use this device, two attending surgeons performed a proctored simulation using a realistic, pulsatile, and bleeding human neck model. The simulation was created by 3D printing injection molds and casting anatomically correct polymer components. The following day, the TCAR procedure was performed on an 81-year-old man with symptomatic right carotid stenosis.

Results: The TCAR procedure was successfully performed in the simulation model and in the live patient. The surgeons reported that the simulation allowed them to learn the procedure under risk-free but realistic operative conditions. The patient did not have any immediate or long-term adverse events.

Conclusions: Replicating human anatomy using 3D printing and multilayer polymer hydrogels provides a cost-effective opportunity to practice using novel surgical technologies before attempting live cases.


carotid stenosis; novel device; endarterectomy;