A Steerable and Electromagnetically Tracked Catheter: Navigation Performance Compared With Image Fusion in a Swine...

Area of Science:

• Vascular Surgery
• Medical Device Technology
• Interventional Radiology

Background:

• Cannulating visceral vessels is crucial for fenestrated and branched endovascular aortic repair.
• Reducing radiation and contrast dye exposure during these procedures is a significant clinical goal.

Purpose of the Study:

• To evaluate the cannulation performance of a novel electromagnetically (EM) trackable and manually steerable catheter.
• To compare EM tracking navigation against conventional image fusion guidance in a preclinical swine model.

Main Methods:

• Seven operators performed cannulations of visceral arteries (renal, SMA, celiac trunk) in three pigs.
• Cannulation attempts were made using 3D image navigation with EM tracking and subsequently with image fusion.
• Success rates, procedure times, and radiation exposure were recorded.

Main Results:

• Both EM tracking and image fusion achieved similar cannulation rates on the first attempt (79%).
• No statistically significant differences were observed in cannulation rates or procedure times between the two navigation methods.
• Image fusion achieved a 97% success rate when multiple attempts were permitted.

Conclusions:

• The steerable and EM trackable catheter demonstrated feasibility for 3D image navigation in visceral vessel cannulation.
• EM tracking navigation performance was comparable to image fusion, suggesting potential for reduced radiation and contrast use.
• Further clinical studies are warranted to validate its utility in patients undergoing endovascular aortic repair.