• Vascular Annual Meeting
• Call for Abstracts
• General Information
• Exhibitor Information
• Alumni Association Information
• 2009 Meeting Information
• Future Meeting Dates
• Contact Us

Home > Vascular Annual Meeting > SS30. The Role of Robotic Endovascular Catheters...

SS30. The Role of Robotic Endovascular Catheters in Fenestrated Stent Grafting

Celia V. Riga, Colin D. Bicknell, Mohamad S. Hamady, Nicholas J. Cheshire
St Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom

OBJECTIVES: Advances in stent graft technology have allowed the treatment of complex thoraco-abdominal aneurysm disease via a total endovascular approach but the procedure can be technically challenging and time consuming.

METHODS: A 4-vessel fenestrated stent graft partially deployed within a CT-reconstructed pulsatile Type-II thoraco-abdominal aneurysm silicon model was used. Twelve vascular specialists were asked to cannulate the renal and visceral vessels under fluoroscopic guidance, using conventional and robotic techniques. Quantitative (catheterization times and wire/catheter tip movements) and qualitative metrics (validated procedure-specific-rating scale (IC3ST), which grades operators on catheter use, instrumentation, successful cannulation/catheterization and overall performance assessed by two blinded observers (Cronbach’s α=0.94)) were compared (Wilcoxon signed-rank test).

RESULTS: Median procedure times for cannulation of all 4 vessels were reduced using robotic catheters (2.9min IQR (2.3-4.2) versus 14 min (11.1-19.6); p=0.002). The total number of wire/catheter movements taken to complete the task was also significantly reduced (38 IQR (27.3-64.8) vs. 423 (221-662); p=0.002). There were significant differences in time and movement for cannulation of each individual vessel in the phantom. Robotic catheter operator radiation exposure was minimal. Procedure-specific performance scores were significantly improved with robotic catheterization despite minimal operator exposure (IC3ST score 29/35 IQR(21.8-30.6) vs. 18.8/35 (11.5-24.1); p=0.006).

CONCLUSIONS: Robotic catheterization of target vessels during this procedure is feasible and minimizes radiation exposure for the operator. Steerable robotic catheters with intuitive control may overcome some of the limitations of standard catheter technology, enhance target vessel cannulation, reduce instrumentation and improve overall performance scores.

AUTHOR DISCLOSURES: C.V. Riga, None; C.D. Bicknell, None; M.S. Hamady, None; N.J. Cheshire, None.