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Feasibility and safety of remote endovascular catheter navigation in a porcine model.
MedLine Citation:
PMID:  21521066     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Abstract Purpose: To evaluate the feasibility and safety of a redesigned remotely operated vascular catheter versus manual catheter manipulation in a porcine model. Methods: Following femoral artery puncture and wire insertion, 4 pigs had either a robotically steered catheter (3 animals) or standard manual catheter manipulation to cannulate the contralateral iliac artery, bilateral renal arteries, and the superior mesenteric artery. After harvesting, the vessels were evaluated histologically by an independent laboratory using hematoxylin and eosin staining. Each cannulated artery was assessed for disruption of the intimal surface, intimal thrombus, damage to the tunica muscularis (dissection), mural hemorrhage, and inflammation by a pathologist who was blinded to the technique utilized for cannulation. Results: No histological evidence of intimal thrombus, disruption, inflammation, or hemorrhage was demonstrated in any vessel section from the robotic cases. In the SMA, 1 of 61 sections from the robotic cases demonstrated mild focal dissection, while 1 of 9 slices from the manual control showed intimal thrombus. Of 129 slices from the renal arteries catheterized by the robotic system, 4 sections demonstrated mild focal dissection, while 2 of 23 sections from the manual control showed grade 1 intimal thrombus. In the iliofemoral arteries, 3 of 91 sections showed mild focal dissection in the robotic cases; in the manual control, 1 of 9 slices demonstrated extensive dissection and another showed mild intimal thrombus. Conclusion: The robotically operated catheter was at least as safe as manual manipulation. More extensive injury was actually observed with the manual technique. This newly designed robotic catheter has the potential to offer many advantages in terms of flexibility and range of motion.
Authors:
Jean Bismuth; Elika Kashef; Nicholas Cheshire; Alan B Lumsden
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  18     ISSN:  1545-1550     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  243-9     Citation Subset:  IM    
Affiliation:
1 The Methodist Hospital, DeBakey Heart & Vascular Center, Houston, Texas, USA.
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