Volume 49, Issue 3 Fall 2025 JVU 493-156 | Simulated Ballistic Gelatin Mold for Ultrasound-Guided Pseudoaneurysm Injection Training-Simulated Ballistic Gelatin Mold

Simulated Ballistic Gelatin Mold

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This educational article from the Journal for Vascular Ultrasound details a cost-effective, reproducible simulation model designed to train vascular medicine fellows in ultrasound-guided thrombin injection for pseudoaneurysms. A pseudoaneurysm is a vascular complication arising from arterial wall injury, often due to invasive procedures like catheterization, characterized by blood collecting outside the vessel wall. Clinically presenting as a pulsatile mass, pseudoaneurysms are treated with ultrasound-guided compression, thrombin injection, or surgery.<br /><br />To prepare fellows for this procedure, an annual workshop is conducted using a ballistic gelatin mold embedded with small water balloons filled with red dye to mimic pseudoaneurysms. The training enhances hand-eye coordination, procedural setup familiarity, sterile technique, needle visualization, and team communication. During the simulation, fellows practice needle insertion under B-mode ultrasound guidance; successful puncture is confirmed by dye blood return, followed by simulated thrombin injection producing a color Doppler flash.<br /><br />The article provides step-by-step instructions for creating the mold: filling and taping 20 small balloons with red dye, securing them with tape “feet” inside a plastic container, then pouring prepared, colored, microwave-heated gelatin over them. The gelatin, mixed to an applesauce-like consistency and dyed red/blue to obscure balloon visibility, solidifies overnight to form a realistic tissue analog for ultrasound visualization and puncture practice.<br /><br />Key recommendations include using new balloons to prevent rupture, unflavored gelatin to avoid cracking, gentle stirring to prevent air bubbles, and adequate heating to ensure mold stability. Feedback from fellows confirmed the simulation’s value, boosting confidence and procedural skills.<br /><br />Overall, this innovative, low-cost simulation tool provides crucial hands-on experience for safe and effective ultrasound-guided pseudoaneurysm injection, enhancing training quality and patient outcomes in vascular medicine.

Keywords

vascular ultrasound

pseudoaneurysm

thrombin injection

simulation model

vascular medicine training

ultrasound-guided procedure

ballistic gelatin mold

needle visualization

procedural skills

medical education