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Session: Medical Instruments - Surgery II
Session starts: Friday 25 January, 13:00
Presentation starts: 13:30
Room: Lecture room 557

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Helene Clogenson (TUDelft-Dept. of BioMechanical Engineering )
John van den Dobbelsteen (TUDelft-Dept. of BioMechanical Engineering )
Jenny Dankelman (TUDelft-Dept. of BioMechanical Engineering )

Abstract:
Endovascular interventions have proven to be successful with millions of patients annually diagnosed and treated worldwide. However, this technique presents several weaknesses. The manoeuvrability of these instruments determines whether the target can be successfully reached. Yet, conventional endovascular instruments, catheters and guide-wires, are limited in shape and flexibility and therefore difficult to steer and control [1]. Furthermore endovascular interventions are performed under 2D fluoroscopy/angiography guidance, exposing patient and staff to accumulating ionizing radiations dozes. Consequently, any difficulties in navigating increase the exposure of patient and staff. Magnetic resonance imaging (MRI), on the other hand, has no known harmful effects, offers several advantages for both patients and interventionalist [2, 3]. The goal of this project is to develop an MRI-compatible and steerable endovascular instrument with improved manoeuvrability. In order to achieve more insight in the design requirements of steerable instruments for interventional procedures an experimental study was performed. While navigating the instruments, time-action analysis was used to investigate the relation between the geometry of bifurcations, the shape of catheters and the time taken to perform specific actions Based on the results of this study a 60cm long, 6Fr, polymer based, MRI-compatible catheter with a two-degree-of-freedom tip has been designed and is currently been assembled. Once realized the proposed instrument will provide the opportunity to steer, or adjust, the instrument tip to adapt to the geometry of the anatomy and bifurcation, thereby directly improving the distal control of the instruments. An evaluation of this steerable prototype will be performed. First, the main mechanicals properties of the prototype, such as stiffness and torque, will be measured. Then the instrument will be manipulated and evaluated in a vascular model with novices. Finally in-vitro and in-vivo experiments will be planned with experienced interventional radiologists. REFERENCES 1. Fu Y, L.H., Huang W, Wang S, Liang Z., Steerable catheters in minimally invasive vascular surgery. Int J Med Robot., 2009. 5(4): p. 381-91. 2. Saikus CE, L.R., Interventional cardiovascular magnetic resonance imaging: a new opportunity for image-guided interventions. JACC Cardiovasc Imaging., 2009. 2(11): p. 1321-31. 3. Krämer NA, K.S., Schmitz S, Linssen M, Schade H, Weiss S, Spüntrup E, Günther RW, Bücker A, Krombach GA., Preclinical evaluation of a novel fiber compound MR guidewire in vivo. Invest Radiol., 2009. 44(7): p. 390-7.