Current state in tracking and robotic navigation systems for application in endovascular aortic aneurysm repair

Ruiter, Quirina M.B. de; Moll, Frans L.; Herwaarden, Joost A. van

doi:10.1016/j.jvs.2014.08.069

Cited by 33 publications

(21 citation statements)

References 37 publications

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“…Its advantages in terms of catheterization times, absolute number of movements of the catheter tip and number of wall hits have been demonstrated in-vitro [8][9][10]. But in a recent literature review on endovascular navigation systems [11], the authors concluded that there were not enough proof of the superiority of such robotically driven catheters over classical techniques and that robotic systems should be reserved only in case of conventional techniques failures.…”

Section: Introductionmentioning

confidence: 99%

Design and Experimental Validation of an Active Catheter for Endovascular Navigation

Couture

Szewczyk

2017

Journal of Medical Devices

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Endovascular technique has many advantages but relies strongly on operator skills and experience. Robotically steerable catheters have been developed but few are clinically available.We describe here the development of an active and efficient catheter based on Shape Memory Alloys (SMA) actuators.We first establish the specifications of our device considering anatomical constraints. We then present a new method for building active SMA-based catheters. The proposed method relies on the use of a core body made of three parallel metallic beams and integrates wire-shaped SMA actuators. The complete device is encapsulated into a standard 6F catheter for safety purposes.A trial-error campaign comparing 70 different prototypes is then conducted to determine the best dimensions of the core structure and of the SMA actuators with respect to the imposed specifications. The final prototype is tested on a silicon-based arterial model and on a 23-kg pig.During these experiments we were able to cannulate the supra-aortic trunks and the renal arteries with different angulations and without any complication. * Corresponding authorA second major contribution of this paper is the derivation of a reliable mathematical model for predicting the bending angle of our active catheters. We first use this model to state some general qualitative rules useful for an iterative dimensional optimization. We then perform a quantitative comparison between the actual and the predicted bending angles for a set of 13 different prototypes. It happens that the relative error is less than 20% for bending angles between 100° and 150° which is the interval of interest for our applications.challenging and may result in an unsuccessful procedure. In most cases, several material exchanges are needed in one procedure, increasing the operative time. Several endovascular robotic systems have been developed to improve catheter navigation and reduce both the operating time and material.

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Section: Introductionmentioning

confidence: 99%

Design and Experimental Validation of an Active Catheter for Endovascular Navigation

Couture

Szewczyk

2017

Journal of Medical Devices

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“…With endovascular procedure complexity, the amount of intra-arterial administered iodinated contrast media increases substantially. At the same time, new techniques like fusion image road-mapping and robotic navigation have been applied and are under further development to reduce procedural iodinated contrast volume and accelerate complex EVAR procedures [ 5 , 6 ]. For proper risk analysis and adequate procedure management, knowledge of predictors of renal function following complex EVAR is required.…”

Section: Introductionmentioning

confidence: 99%

Endovascular treatment of complex aortic aneurysms: prevalence of acute kidney injury and effect on long-term renal function

et al. 2015

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ObjectivesTo analyse predictors for short- and long-term renal function changes after fenestrated and branched endovascular aortic repair (EVAR).MethodsA total of 157 patients underwent fenestrated and branched EVAR. Procedural intra-arterial iodinated contrast volume was documented. Serum creatinine and estimated glomerular filtration rate (eGFR) at baseline, during 48 h following EVAR, at discharge and latest moment of follow-up were recorded. Development of post-EVAR acute kidney injury (AKI; according to AKIN criteria), and potential risk factors for renal failure were recorded. Multivariate regression analyses were used to identify independent risk factors for AKI and eGFR decrease during follow-up.ResultsForty-three patients (28 %) developed post-EVAR AKI. Long procedure time and occlusion of accessory renal arteries were independent risk factors for development of AKI. (odds ratio (OR) 1.005 per minute, 95 % CI 1.001–1.01; p = 0.025 and OR 3.02, 95 % CI 1.19–8.16; p = 0.029). Post-EVAR AKI was associated with a significantly increased risk for eGFR decrease at discharge and latest follow-up (hazard ratio (HR) 3.47, 95 % CI 1.63–7.36, p = 0.001 and HR 3.01, 95 % CI 1.56–5.80; p = 0.001). Iodinated contrast volume was not an independent risk factor for AKI or eGFR decrease during follow-up.ConclusionDevelopment of post-EVAR AKI is an independent risk factor for long-term renal function decrease.Key Points• Longer procedure time is associated with an increased risk for AKI.• Renal perfusion defects on angiography are associated with increased risk for AKI.• Post-EVAR AKI is associated with higher probability for long-term eGFR decrease.• Iodinated contrast volume is not an independent risk factor for AKI.• Iodinated contrast volume is not an independent risk factor for long-term eGFR decrease.

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“…In addition to this, the robotic navigation systems have been applied in phantom and animal studies in EVAR. Their benefits, such as improving aortic vessel cannulation, reduce fluoroscopy time, radiation doses and contrast volumes require clinical trials confirming advantages of robotic navigation technologies in endovascular procedure for AAA repair (50).…”

Section: Laparoscopic Approach and Robots Techniquementioning

confidence: 98%

Endovascular Aneurysm Repair or Open Aneurysm Repair for the Treatment of Abdominal Aortic Aneurysm – The Latest Update

Kulig¹,

Lewandowski²,

Ziaja³

et al. 2016

Polish Journal of Surgery

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Current state in tracking and robotic navigation systems for application in endovascular aortic aneurysm repair

Cited by 33 publications

References 37 publications

Design and Experimental Validation of an Active Catheter for Endovascular Navigation

Design and Experimental Validation of an Active Catheter for Endovascular Navigation

Endovascular treatment of complex aortic aneurysms: prevalence of acute kidney injury and effect on long-term renal function

Endovascular Aneurysm Repair or Open Aneurysm Repair for the Treatment of Abdominal Aortic Aneurysm – The Latest Update

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