Novel EM Guided Endovascular Instrumentation for In Situ Endograft Fenestration

Figures

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  FIGURE 1.. Diagram of the endovascular navigator: the software (in cyan) and the hardware (in grey) modules, the surgeon/user (in red), the developed instrumentation (in green), testing in vitro setups (in yellow). Physical interactions and data transfers are represented with directional lines.

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  FIGURE 2.. Overview of developed sensorized laser guidewire. The EM coil and the laser fiber are both integrated within the nitinol hollow strand, as shown in the zoomed detail.

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  FIGURE 3.. Overview of stabilizer (a): from navigation configuration (b) the nitinol components are expanded in working configuration (c) by pulling (yellow direction) the slidable handle (white arrowhead).

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  FIGURE 4.. Overview of steerable catheter (a): the straight distal part of the tip (b) can be bent (c) by turning the cog (white arrowhead) of the handle.

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  FIGURE 5.. In vitro testing setups: Setup A, a non-anthropomorphic phantom (a); and Setup B, a phantom of a short-necked aneurysm (b).

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  FIGURE 6.. EM-guided mechanical ISF: the navigator scene (a) allows the user to position the stabilizer (white arrowhead) and orient the steerable catheter (asterisk) at the target site (visible also in the endoscopic view). A successful mechanical ISF is shown in the real scene (b), where the sharp-end of the guidewire perforated the endograft wall.

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  FIGURE 7.. Overview of Setup B for laser ISF (a): the navigator scene (b) allows the user to position the stabilizer (green) and orient the steerable catheter (blue) at the target site (visible also in the endoscopic view). A successful laser ISF is shown in the real scene (c), where the sensorized laser guidewire perforated the endograft wall at left renal level.