In vitro fenestrated endovascular aortic repair deployment and cannulation using an electromagnetically steerable...

Area of Science:

• Vascular Surgery
• Medical Device Technology
• Interventional Cardiology

Background:

• Precise guidewire navigation is essential for successful branched and fenestrated endovascular aortic repair (FEVAR).
• Target vessel cannulation in FEVAR often necessitates the use of multiple complex devices, increasing procedural time and risk.
• Minimally invasive techniques are continuously sought to improve outcomes in complex aortic interventions.

Purpose of the Study:

• To evaluate the feasibility of using electromagnetic guidewire navigation for target vessel cannulation in a FEVAR model.
• To assess the efficacy of a magnetically steerable guidewire in navigating fenestrations and accessing renal and visceral arteries.
• To determine if this technology can reduce the reliance on adjunctive devices during FEVAR.

Main Methods:

• A custom-made endograft was deployed in a three-dimensional silicone thoracoabdominal aneurysm model.
• Femoral access was used to cannulate renal and visceral arteries with a magnetically steerable guidewire.
• Electromagnetic navigation system was employed to guide the guidewire through four fenestrations.

Main Results:

• Successful cannulation of all four target vessels was achieved using only the magnetic guidewire.
• Three of the four target vessels were successfully stented without the need for additional support catheters or steerable sheaths.
• The electromagnetic navigation system demonstrated accuracy in guiding the guidewire through the fenestrations.

Conclusions:

• Electromagnetic guidewire navigation is a feasible technique for target vessel cannulation in FEVAR.
• This technology has the potential to simplify FEVAR procedures by reducing the need for adjunctive devices.
• Magnetically guided navigation may offer a less complex alternative for complex aortic repair interventions.