AngioSim: A Novel Augmented-Reality Angiography Simulator for Radiation-Free Neurointerventional Training

Cardiovascular diseases require fast and precise treatment, often involving angiography for diagnosis and intervention. However, training in angiographic procedures often entails exposure to ionizing radiation, which carries inherent risks. To reduce this exposure and enhance training realism, we developed AngioSim—a novel augmented-reality angiography simulation system combined with a vascular silicone simulator. This study evaluates the realism, effectiveness, and potential benefits of AngioSim for neurointerventional training. AngioSim was tested during neurointerventional training sessions with 24 physicians at RWTH Aachen University Hospital. Participants completed a questionnaire assessing realism, usefulness, and preferences compared to other simulators using a Likert scale. Responses were converted to binary categories and McNemar tests were applied for paired comparisons. A total of 92% of physicians rated guidewire and catheter visibility during fluoroscopy as sufficient, while 86% found RM and DSA simulations realistic. AngioSim was preferred over camera-based silicone simulators by 93%, and 96% of physicians rated it necessary for training—significantly more than other simulators (p < 0.05). These results demonstrate the high acceptance and perceived realism of the system and suggest that AngioSim offers advantages over existing training methods. AngioSim offers a realistic, cost-effective, and radiation-free training solution while maintaining the benefits of silicone models. It showed high utility for training purposes, making it a promising addition to neurointerventional programs.