Future robotic catheter systems could enhance endovascular methods of treatment

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Dr Nick Cheshire, Imperial College, London, UK, presented early data on the Hansen Robotic System (Sensei) at the VEITHsymposium 2008, and explained that intuitive robotic catheter systems may help to overcome the limitations of standard catheter technology. He also stated that further development of this technology may improve clinical outcomes.

The aim of Cheshire and colleague’s research was to determine the feasibility of robotic endovascular catheterisation using pulsatile flow models, as well as compare conventional vs. robotic vessel cannulation. Ten endovascular specialists (>50 procedures each) were asked to cannulate vessels within CT-reconstructed pulsatile models of Type-I, Type-III aortic arches and a fenestrated graft within a Type-II thoracoabdominal aneurysm. The procedures were performed with fluoroscopic guidance using conventional and robotic techniques following a standardised training. Cannulation times were recorded and wire/catheter tip movements were assessed by two independent observers.

Results
According to Cheshire, the results of the study showed that despite minimal robotic catheter operator exposure, procedure times, operator radiation exposure and wire/catheter movements are significantly reduced.
In the fenestrated stent model, there were significant improvements in time and movements for all vessels cannulated with the robotic system. Cheshire explained, “These results suggest that complex endovascular procedures may well benefit from the use of a robotic steerable catheter.”

Conclusions
In summary, Cheshire stated that, “Robotic cannulation of target vessels in pulsatile flow models is feasible, and despite minimal operator exposure to the robotic system, time and instrumentation were significantly reduced. The greatest differences were observed in challenging anatomical configurations.”
He further concluded that additional development of the robotic catheter system could increase the applicability of endovascular therapy.