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Published on: June 12, 2021
Stabilizing interventional instruments in the cardiovascular system: A classification of mechanisms
Awaz Ali1, Dimitra Dodou2, Gerwin Smit3
1PhD candidate at TU Delft, Delft University of Technology, Faculty of Mechanical, Maritime and Materials Engineering, Department of BioMechanical Engineering, Delft, Zuid-Holland, the Netherlands.
Insights
Stabilizing catheters in cardiac interventions is complex. This review classifies mechanisms into surface-based and volume-based, aiding future device design and addressing challenges in catheter positioning.
Area of Science:
- Interventional Cardiology
- Biomedical Engineering
- Medical Device Design
Background:
- Accurate catheter positioning and stabilization are critical for successful interventional cardiology procedures.
- Current methods face challenges in maintaining stable catheter placement within vessels and the heart.
Purpose of the Study:
- To systematically classify existing catheter stabilization mechanisms used in cardiac interventions.
- To identify challenges and define requirements for future cardiac catheter design.
Main Methods:
- A structured classification of commercially available, patented, and experimental catheter prototypes based on their stabilization mechanisms.
- Analysis of stabilization techniques, categorizing them into surface-based and volume-based approaches.
Main Results:
- Identified two primary stabilization mechanisms: surface-based (anchoring) and volume-based (shape or force locking).
- The classification provides a framework for understanding current technologies and their limitations.
Conclusions:
- The classification offers insights into existing catheter stabilization methods and can guide the development of novel mechanisms.
- Addressing identified challenges can lead to more dedicated, patient-specific catheter systems for improved interventional outcomes.
Abstract:
Positioning and stabilizing a catheter at the required location inside a vessel or the heart is a complicated task in interventional cardiology. In this review we provide a structured classification of catheter stabilization mechanisms to systematically assess their challenges during cardiac interventions. Commercially available, patented, and experimental prototypes of catheters were classified with respect to their stabilizing mechanisms. Subsequently, the classification was used to define requirements for future cardiac catheters and persisting challenges in catheter stabilization. The classification showed that there are two main stabilization mechanisms: surface-based and volume-based. Surface-based mechanisms apply attachment through surface anchoring, while volume-based mechanisms make use of locking through shape or force against the vessel or cardiac wall. The classification provides insight into existing catheter stabilization mechanisms and can possibly be used as a tool for future design of catheter stabilization mechanisms to keep the catheter at a specific location during an intervention. Additionally, insight into the requirements and challenges for catheter stabilization inside the heart and vasculature can lead to the development of more dedicated systems in the future, allowing for intervention- and patient-specific instrument manipulation.
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