Multi-selective catheter for MR-guided endovascular interventions.
Selective catheters have predefined distal shapes and need to be exchanged to change tip geometry to facilitate selective catheterization of vascular side branches. These repeated insertions increase the risk of endovascular injury and radiation dose in conventional catheterization laboratories. The aim of this study is to develop a multi-selective catheter that can replace three conventional selective catheters that are commonly used sequentially in a single procedure. By integrating the different shapes in one instrument, it is possible to avoid the required time-consuming exchange. This new instrument is also made compatible with magnetic resonance imaging (MRI) guidance, which, unlike X-ray, presents variable soft tissue contrast without the use of ionizing radiation. A 1.2 m long and 2.15 mm diameter deflectable polymer-based catheter was assembled and three widely used selective catheters could be mimicked. The instrument was visible on the images without producing unwanted artifacts in an abdominal model and in an animal under real-time MRI guidance. Simple navigation tasks were performed together with a 0.035 in. MRI-safe guidewire. In these tasks, the iliac, renal, brachiocephalic, and left subclavian arteries were cannulated only by using the shape setting and without exchange of the instruments.
Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628CD Delft, The Netherlands. Electronic address: H.C.Clogenson@tudelft.nl.
Helene C M
HC
Clogenson
Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628CD Delft, The Netherlands.
Joris Y
JY
van Lith
Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628CD Delft, The Netherlands.
Jenny
J
Dankelman
Institute for Medical Science and Technology IMSaT, University Dundee, Dundee Medipark, Dundee DD2 1FD, Scotland.
Andreas
A
Melzer
Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628CD Delft, The Netherlands.
John J
JJ
van den Dobbelsteen
D000005:Abdomen / Q000098:blood supply / Q000601:surgery; D000818:Animals; D001011:Aorta / Q000601:surgery; D057785:Catheters; D057510:Endovascular Procedures / Q000295:instrumentation*; D004867:Equipment Design; D008279:Magnetic Resonance Imaging / Q000295:instrumentation; D053783:Magnetic Resonance Imaging, Interventional / Q000295:instrumentation*; D008955:Models, Cardiovascular; D013552:Swine
Catheters; Deflectable; Interventional radiology; Magnetic resonance imaging guided interventions; Navigation; Steerable