Novel EM Guided Endovascular Instrumentation for In Situ Endograft Fenestration.
S Condino1,2, R Piazza1,2, R M Viglialoro2
11Information Engineering DepartmentUniversity of Pisa56122PisaItaly.
Summary
Novel instruments improve in situ endograft fenestration, addressing targeting and support challenges. Preliminary trials show feasibility, potentially expanding endovascular aneurysm repair for acute syndromes.
Area of Science:
- Biomedical Engineering
- Vascular Surgery
- Medical Devices
Background:
- Current endograft fenestration techniques face limitations in precise targeting and mechanical support during perforation.
- These challenges hinder the widespread adoption of in situ fenestration procedures.
Purpose of the Study:
- To develop and evaluate novel endovascular instrumentation for improved in situ endograft fenestration.
- To overcome technical difficulties in targeting and stabilizing fenestration devices under fluoroscopic guidance.
Main Methods:
- Development of electromagnetically trackable instruments for enhanced navigation and stabilization.
- In vitro evaluation of the instrumentation using a custom laser guidewire and a commercial guidewire for antegrade fenestration of aortic endografts.
Main Results:
- Successful in situ fenestration was achieved in 22 trials.
- One laser tool experienced sensor damage due to tip over-bending, necessitating the use of a second device.
Conclusions:
- Preliminary in vitro results indicate the feasibility of the novel instrumentation for in situ endograft fenestration.
- Further validation through animal studies is recommended to confirm efficacy and safety.
- The technology holds potential to broaden the application of endovascular aneurysm repair, particularly for acute syndromes.
