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Related Concept Videos

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Development and Evaluation of 3D-Printed Cardiovascular Phantoms for Interventional Planning and Training
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Experimental Protocol and Phantom Design and Development for Performance Characterization of Conventional Devices for

Yara Alawneh1, James J Zhou1, Alykhan Sewani1

  • 1Faculty of Engineering and Architectural Science, Toronto Metropolitan University (Formerly Ryerson University), Toronto, ON, Canada.

Annals of Biomedical Engineering
|February 22, 2023
PubMed
Summary

Steerable catheters significantly improve target access and force delivery in peripheral artery interventions compared to non-steerable ones. This study quantifies limitations in conventional catheter performance for better device development.

Keywords:
AngioplastyCatheter limitationsCatheter manipulationCatheter navigationChronic total occlusionsEndovascularGuidewiresNon-steerable catheterPeripheral vascular interventionsSteerable catheter

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Area of Science:

  • Vascular Surgery
  • Medical Device Engineering
  • Interventional Radiology

Background:

  • Peripheral artery disease interventions face high failure rates due to device limitations.
  • Conventional catheters exhibit poor controllability, limited pushability, and inadequate anatomical feedback during procedures.
  • Current imaging modalities like 2D X-ray fluoroscopy lack precise device localization.

Purpose of the Study:

  • To quantitatively assess and compare the performance of conventional non-steerable (NS) and steerable (S) catheters.
  • To evaluate catheter-based intervention limitations in terms of navigation, workspace, and force delivery.
  • To establish a performance benchmark for future peripheral intervention device development.

Main Methods:

  • Phantom and ex vivo experiments were conducted using a 10 mm diameter, 30 cm long artery model.
  • Four operators evaluated target access success rate, crossing time, accessible workspace, and delivered force for both NS and S catheters.
  • Ex vivo chronic total occlusions (fixed and fresh lesions) were used to assess crossing success and time.

Main Results:

  • Steerable catheters achieved a 69% target access success rate versus 31% for non-steerable catheters.
  • Operators accessed 68% of the cross-sectional area with steerable catheters compared to 45% with non-steerable ones.
  • Mean force delivered was 14.2 g for steerable and 10.2 g for non-steerable catheters; 0% of fixed lesions were crossed with NS catheters.

Conclusions:

  • Conventional catheters possess significant limitations in navigation, workspace, and pushability for peripheral interventions.
  • Steerable catheters demonstrate superior performance in target access, workspace utilization, and force delivery.
  • This quantitative analysis provides a critical baseline for evaluating novel devices in peripheral interventions.