Magnetic guide-wire navigation in pulmonary and systemic arterial catheterization: initial experience in pigs.
OBJECTIVE
Cardiovascular catheterization can be challenging whenever a stenosis or an abnormal vascular course interferes with probing the target vessel. This study addresses the feasibility of navigating a guide wire with a magnetic tip by an external magnetic field through pulmonary and systemic arteries in an experimental porcine model.


METHODS
We investigated six piglets using magnetic guide-wire navigation. Two pulmonary arteriograms were taken from different angles in order to reconstruct the three-dimensional vessel anatomy. A computer interface then calculated three-dimensional coordinates for the vessel in space. Using these coordinates, two external magnets were positioned to create magnetic vectors along the expected vessel course. Magnetically enabled guide wires were then navigated into the vessels using the magnetic field to orient the guide-wire tips. Aortic and renal branches were addressed in a similar fashion. Difficulty in reaching the target vessel was reflected by the number of attempts that were necessary. After 10 failed attempts, the maneuver was recorded to have failed.


RESULTS
Thirty-five of 37 (94.6%) arteries with branches at acute angles were reached successfully using magnetic navigation. In two pigs, the left upper lobe artery could not be probed. Peripheral arteries of small diameter were easier to reach than large central arteries, requiring less attempts.


CONCLUSIONS
Magnetic guide-wire navigation is feasible in the arteries of the lungs, the head and neck, and the kidneys. It is particularly useful in entering small arterial branches at acute angles and may facilitate interventional therapy in a variety of vascular diseases in children and adults.
Grosse-Wortmann
Lars
L
Department of Pediatric Cardiology, Aachen University Hospital, Pauwelsstrasse 30, 52057 Aachen, Germany. lgrosse-wortmann@ukaachen.de
Grabitz
Ralf
R
Seghaye
Marie-Christine
MC
D000818:Animals; D001011:Aorta / Q000033:anatomy & histology; D001027:Aortography; D002406:Catheterization, Peripheral / Q000295:instrumentation* / Q000379:methods; D002407:Catheterization, Swan-Ganz / Q000295:instrumentation* / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008280:Magnetics / Q000295:instrumentation*; D011651:Pulmonary Artery / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D012077:Renal Artery / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D013552:Swine