Robotic Ultrasound for Catheter Navigation in Endovascular Procedures

Atrial fibrillation (AF) is linked to an increased risk of adverse cardiovascular events. While rhythm control with antiarrhythmic drugs (AADs) is a common strategy for managing patients with AF, catheter ablation may be a more efficacious and safer alternative to AADs for sinus rhythm control. Conventional catheter ablation has been associated with challenges during the arrhythmia mapping and ablation stages; however, the introduction of two remote catheter navigation systems (a robotic and a magnetic navigation system) may potentially overcome these challenges. Initial clinical experience with the robotic navigation system suggests that it offers similar procedural times, efficacy and safety to conventional manual ablation. Furthermore, it has been associated with reduced fluoroscopy exposure to the patient and the operator as well as a shorter fluoroscopy time compared with conventional catheter ablation. In the future, the remote navigation systems may become routinely used for complex catheter ablation procedures.

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Faculty Opinions recommendation of Technical communication: First robotic ultrasound-guided nerve blocks in humans using the Magellan system.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717973714.793470887 ◽

2013 ◽

Author(s):

Peter Gerner ◽

Thomas Danninger

Keyword(s):

Technical Communication ◽

Ultrasound Guided ◽

Nerve Blocks ◽

Robotic Ultrasound

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Clamping Force Evaluation For A Robotic Catheter Navigation System

Neuroscience and Biomedical Engineering ◽

10.2174/22133852113016660002 ◽

2013 ◽

Vol 666 (666) ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Nan Xiao ◽

Baofeng Gao ◽

Liwei Shi ◽

Zhibin Song ◽

Shuxiang Guo ◽

...

Keyword(s):

Navigation System ◽

Clamping Force ◽

Catheter Navigation

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Impact of augmented-reality improvement in ablation catheter navigation as assessed by virtual-heart simulations of ventricular tachycardia ablation

Computers in Biology and Medicine ◽

10.1016/j.compbiomed.2021.104366 ◽

2021 ◽

Vol 133 ◽

pp. 104366

Author(s):

Adityo Prakosa ◽

Michael K. Southworth ◽

Jennifer N. Avari Silva ◽

Jonathan R. Silva ◽

Natalia A. Trayanova

Keyword(s):

Ventricular Tachycardia ◽

Augmented Reality ◽

Ablation Catheter ◽

Ventricular Tachycardia Ablation ◽

Catheter Navigation

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A Magnetorheological Fluids-Based Robot-Assisted Catheter/Guidewire Surgery System for Endovascular Catheterization

Micromachines ◽

10.3390/mi12060640 ◽

2021 ◽

Vol 12 (6) ◽

pp. 640

Author(s):

Linshuai Zhang ◽

Shuoxin Gu ◽

Shuxiang Guo ◽

Takashi Tamiya

Keyword(s):

Collision Detection ◽

Endovascular Procedures ◽

Force Feedback ◽

Force Measurement ◽

Occupational Hazards ◽

Robot Assisted ◽

X Ray ◽

Surgical Safety ◽

Surgical Tool ◽

Haptic Cues

A teleoperated robotic catheter operating system is a solution to avoid occupational hazards caused by repeated exposure radiation of the surgeon to X-ray during the endovascular procedures. However, inadequate force feedback and collision detection while teleoperating surgical tools elevate the risk of endovascular procedures. Moreover, surgeons cannot control the force of the catheter/guidewire within a proper range, and thus the risk of blood vessel damage will increase. In this paper, a magnetorheological fluid (MR)-based robot-assisted catheter/guidewire surgery system has been developed, which uses the surgeon’s natural manipulation skills acquired through experience and uses haptic cues to generate collision detection to ensure surgical safety. We present tests for the performance evaluation regarding the teleoperation, the force measurement, and the collision detection with haptic cues. Results show that the system can track the desired position of the surgical tool and detect the relevant force event at the catheter. In addition, this method can more readily enable surgeons to distinguish whether the proximal force exceeds or meets the safety threshold of blood vessels.

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The Heartguard: A Humanitarian Pediatric Cardiac Surgery Program in Rural China

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0041-1723846 ◽

2021 ◽

Author(s):

Xun E. Zhang ◽

Zhi Geng ◽

Jun Shao ◽

Hao Yao ◽

Lu Wang ◽

...

Keyword(s):

Cardiac Surgery ◽

Endovascular Procedures ◽

Rural China ◽

Surgical Team ◽

Physical And Mental Health ◽

Team Members ◽

Financial Difficulties ◽

The Government ◽

Receive Treatment

Abstract Background Congenital heart disease (CHD) accounts for the most common birth defects in China, pressuring both the physical and mental health in children. The inaccessibility of CHD children in rural China due to financial difficulties is demanding inputs from both the government and society. The Heartguard project is a program developed to improve the delivery of CHD care in rural China. Methods The Heartguard project partners with county hospitals and performs CHD screening to diagnose patients with CHD in rural China. Diagnosed children with CHD who are unable to afford therapy will subsequently receive treatment sponsored by the financial partners. All patients are followed up by the local partner and visiting surgical team members. Results More than 10,000 children across 9 provinces underwent CHD screening. A total of 240 (accounting for an incidence of 2.4%) was treated by the program, of which 226 patients were managed invasively, the other 14 patients conservatively. Open surgery was performed in 162 patients, while endovascular procedures were applied in another 64. No mortality or significant complications occurred during the transfer. There was no perioperative or late death. Conclusion This humanitarian cardiac surgery program is able to promote accessibility of care for CHD children in rural China. The quality of life of these patients can be improved with continuous input from the society.

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Delayed leukoencephalopathy from suspected polymer embolism after neuroendovascular procedures

The Neuroradiology Journal ◽

10.1177/19714009211029172 ◽

2021 ◽

pp. 197140092110291

Author(s):

Thomas Mellemkjær ◽

Ronil V Chandra ◽

Lasse Speiser ◽

Benedicte P Ulhøi ◽

Claus Z Simonsen

Keyword(s):

Polymer Material ◽

Endovascular Procedures ◽

Rare Complication ◽

Diagnostic Process ◽

Line Treatment ◽

Review Of The Literature ◽

First Line ◽

Stroke Treatment ◽

Oral Glucocorticoids ◽

First Line Treatment

As the neurointervention field grows, a new side effect emerges. Delayed leukoencephalopathy (DL) is believed to be an inflammatory or allergic reaction to polymer material that is shed from catheters during endovascular procedures. We present four cases of DL after aneurysm treatment in two patients, endovascular stroke treatment and diagnostic arteriography. We present our diagnostic process, including biopsy results in two patients, our anti-inflammatory treatment and outcomes together with a review of the literature. In our series, prognosis was variable with ongoing seizures in two patients. Our literature review reveals that asymptomatic shedding of polymer material is common, occurring in a third of endovascular stroke procedures, whereas symptomatic DL occurs in <0.5% of therapeutic neuroendovascular procedures. Clinicians should be aware of this rare complication, and oral glucocorticoids seem to be a reasonable first-line treatment strategy.

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