3B P60 Manual Del Usuario página 5

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• Fill up the infusion bottle with artificial blood and then remove all air from the infusion system and
from the artificial vessel system of the simulator until the artificial blood starts to flow into the reservoir
(see also chapter 2)
Fig. 2
Simulator after set-up with a full infusion and vessel system
• Sweep over the surface of the simulator with the probe in the area where the cannula is to be inserted.
• Fill the syringe with the desired sclerosing agent and put it down ready for use. Use an injection cannula
of between 30 and 50 mm in length.
• Position the ultrasound probe and try to find the longitudinal direction in which the puncture is to be
carried out.
Fig. 3 [4]
A longitudinal section of the ultrasound image of the artificial vena saphena magna
• To keep the ultrasound probe stable, support the hand, and hold in the other hand the syringe that has
been filled with the sclerosing agent.
• Carry out the puncture on the upper thigh with the cannula, approximately in the middle of the ultra-
sound probe, at an angle of 45°.
Fig. 4 [4]
Carry out the ultrasound guided injection on the simulator with the syringe at a 45° angle
• Watch the path of the cannula on the screen of the ultrasound device, and carefully move the cannula
longitudinally towards the vessel wall.
• As soon as the vessel wall has been punctured, move the cannula forwards until the tip and bevel can be
seen in the middle of vascular lumen.
Fig. 5 [4]
Ultrasound image of the correct intraluminal position of the tip of the cannula in the artificial vena saphena magna
• Aspirate the artificial blood visibly into the syringe to make sure that the cannula has been placed in the
correct intraluminal position.
Fig. 6 [4]
Aspirate the artificial blood into the syringe before injecting the sclerotherapy medication
• Hold the position of the ultrasound probe and the cannula, and follow its position on the screen of the
ultrasound device. Inject the sclerosing agent slowly and continuously.
If you can make out a white striping (hyperdense = highly echogenic, depending on the medication
used), on the screen of the ultrasound device, in the vessel lumen, you have successfully completed the
ultrasound guided sclerotherapy simulation.
Fig. 7 [4]
Ultrasound guided injection of the medication longitudinally along the vena saphena magna on the simulator
3.5 Summary
The simulator to learn how to carry out ultrasound guided sclerotherapy is suitable both for the purposes
of training students and for advanced training. During training, thanks to the simulator, the student will
become familiarized with the basic movements and the procedure, so that inexperienced practitioners will
not have to learn by carrying out their first procedure on a patient, thus avoiding the possibility of causing
harm.
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