The Columbus steerable guidewire in neurointerventions: early clinical experience and applications

Hessling, Alexander von; Castillo, Tomás Reyes del; Karwacki, Grzegorz Marek; Roos, Justus E.

doi:10.1136/neurintsurg-2021-017296

Cited by 6 publications

(1 citation statement)

References 15 publications

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“…When the guidewire continuously failed to cross the corner (trials 1, 2, 7, 8, and 9 in movie S7), the interventionalist chose to loop the guidewire in the aneurysm to access the desired branch. However, this guidewire looping maneuver can be potentially dangerous, especially in ruptured or in partially thrombosed aneurysms due to the risk of bleeding or displacement of thrombus ( 33 ). We also noticed that the prebent tip of the guidewire occasionally latched onto a small aneurysm (aneurysm 2 in Fig.…”

Section: Resultsmentioning

confidence: 99%

Telerobotic neurovascular interventions with magnetic manipulation

et al. 2022

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Advances in robotic technology have been adopted in various subspecialties of both open and minimally invasive surgery, offering benefits such as enhanced surgical precision and accuracy with reduced fatigue of the surgeon. Despite the advantages, robotic applications to endovascular neurosurgery have remained largely unexplored because of technical challenges such as the miniaturization of robotic devices that can reach the complex and tortuous vasculature of the brain. Although some commercial systems enable robotic manipulation of conventional guidewires for coronary and peripheral vascular interventions, they remain unsuited for neurovascular applications because of the considerably smaller and more tortuous anatomy of cerebral arteries. Here, we present a teleoperated robotic neurointerventional platform based on magnetic manipulation. Our system consists of a magnetically controlled guidewire, a robot arm with an actuating magnet to steer the guidewire, a set of motorized linear drives to advance or retract the guidewire and a microcatheter, and a remote-control console to operate the system under real-time fluoroscopy. We demonstrate our system’s capability to navigate narrow and winding pathways both in vitro with realistic neurovascular phantoms representing the human anatomy and in vivo in the porcine brachial artery with accentuated tortuosity for preclinical evaluation. We further demonstrate telerobotically assisted therapeutic procedures including coil embolization and clot retrieval thrombectomy for treating cerebral aneurysms and ischemic stroke, respectively. Our system could enable safer and quicker access to hard-to-reach lesions while minimizing the radiation exposure to physicians and open the possibility of remote procedural services to address challenges in current stroke systems of care.

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Section: Resultsmentioning

confidence: 99%