title: Robot-assisted antegrade in-situ fenestrated stent grafting.
abstract: To determine the technical feasibility of a novel approach of in-situ fenestration of aortic stent grafts by using a remotely controlled robotic steerable catheter system in the porcine model. A 65-kg pig underwent robot-assisted bilateral antegrade in-situ renal fenestration of an abdominal aortic stent graft with subsequent successful deployment of a bare metal stent into the right renal artery. A 16-mm iliac extension covered stent served as the porcine aortic endograft. Under fluoroscopic guidance, the graft was punctured with a 20-G customized diathermy needle that was introduced and kept in place by the robotic arm. The needle was exchanged for a 4 x 20 mm cutting balloon before successful deployment of the renal stent. Robot-assisted antegrade in-situ fenestration is technically feasible in a large mammalian model. The robotic system enables precise manipulation, stable positioning, and minimum instrumentation of the aorta and its branches while minimizing radiation exposure.
authors.affiliation: Regional Vascular Unit, Imperial College Healthcare, St Mary's Hospital, Waller Cardiac Building, Praed St., London, W2 1NY, UK. c.riga@imperial.ac.uk
authors.forename: Celia V
authors.initials: CV
authors.lastname: Riga
authors.forename: Colin D
authors.initials: CD
authors.lastname: Bicknell
authors.forename: Daniel
authors.initials: D
authors.lastname: Wallace
authors.forename: Mohamad
authors.initials: M
authors.lastname: Hamady
authors.forename: Nicholas
authors.initials: N
authors.lastname: Cheshire
mesh_terms: D000792:Angiography; D000818:Animals; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005240:Feasibility Studies; D012371:Robotics; D015607:Stents; D013552:Swine