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Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology

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Published on: May 26, 2015

FREQUENCY OF AORTIC MISCANNULATION DURING FLUOROSCOPY-FREE ENDOVASCULAR NAVIGATION.

Jason MacTaggart¹, Sruti Prathivadhi¹, Paul Aylward¹

¹Department of Surgery, University of Nebraska Medical Center, Omaha, NE.

Medrxiv : the Preprint Server for Health Sciences

|December 18, 2025

Summary

Fluoroscopy-free aortic cannulation risks guidewire misplacement, especially in patients over 50. This study quantified miscannulation rates using cadavers and simulators, highlighting the need for imaging confirmation to prevent complications.

Keywords:

cadaver electronic simulator fluoroscopy-free navigation miscannulation

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Area of Science:

Vascular Surgery
Medical Simulation
Interventional Radiology

Background:

Aortic wire cannulation is sometimes performed without fluoroscopy for speed.
The risk of guidewire misplacement (miscannulation) during these procedures is not well-quantified.

Purpose of the Study:

To quantify guidewire misplacement rates during fluoroscopy-free aortic cannulation.
To assess the impact of patient age on miscannulation risk.

Main Methods:

Used human cadavers and an electronic endovascular simulator (Mentice VISTG5).
Validated simulator accuracy with cadaveric data.
Analyzed 89 Trauma CT Angiography scans to model vascular variability.
Measured miscannulation frequency using repeated simulator passes.

Main Results:

Aortic miscannulation occurred in 12% of passes in cadavers and the simulator.
In a larger electronic simulation cohort, 36% of subjects experienced miscannulation (10%±18% frequency per pass).
Miscannulation rates were higher in subjects over 50 years old (16%±22%) compared to younger subjects (5%±11%).
Common misplacement sites included iliac, celiac, and superior mesenteric arteries.

Conclusions:

Fluoroscopy-free aortic cannulation is linked to significant miscannulation risks, particularly in older individuals.
Routine fluoroscopic confirmation or advanced endovascular devices are recommended to mitigate complications.