In vitro renal artery stenting using a steerable guide wire navigated by a mobile electromagnetic field

Area of Science:

• Medical Devices
• Interventional Radiology
• Biomedical Engineering

Background:

• Endovascular procedures demand precise guide wire control, often necessitating auxiliary devices, increasing time and resource demands.
• Current catheterization techniques can be time- and resource-intensive due to the need for additional equipment.
• A novel approach utilizes mobile external electromagnetic fields for remote guide wire manipulation, potentially eliminating auxiliary devices.

Purpose of the Study:

• To evaluate the feasibility of a novel technology using external electromagnetic fields for remote guide wire manipulation.
• To compare the efficacy of a magnetically steerable guide wire (MGW) with a conventional guide wire (CGW) in a simulated endovascular procedure.
• To assess the impact of this technology on procedure time, fluoroscopic time, and radiation dose.

Main Methods:

• The study employed a three-dimensional silicone model of the human abdominal aorta.
• Twenty procedures were conducted: 10 using an MGW and 10 using a CGW for renal artery catheterization.
• Technical success rates, procedure times, fluoroscopic times, and fluoroscopic doses were recorded and compared.

Main Results:

• Technical success was 100% for both MGW and CGW groups.
• MGW procedures were significantly shorter, with a median time of 105 seconds compared to 181 seconds for CGW (P < .001).
• A trend towards reduced median fluoroscopic time (65 vs 101 seconds) and dose (6.84 vs 10.98 mGycm²) was observed with MGW.

Conclusions:

• Remote electromagnetic manipulation of steerable guide wires is technically feasible in a simulated human vasculature.
• This technology facilitates in vitro renal artery catheterization and stenting, reducing procedure and fluoroscopy times.
• The novel approach shows potential to enhance the efficiency and safety of various endovascular procedures.