Use of a remotely steerable “robotic” catheter in a branched endovascular aortic graft

• Published in: Journal of vascular surgery Vol. 55; no. 1; pp. 223 - 225
• Main Authors: Carrell, Tom, MA, MChir, FRCS, Dastur, Neville, FRCS, Salter, Richard, FRCR, Taylor, Peter, MA, MChir, FRCS
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 2012; Elsevier
• Subjects: Angiography, Digital Subtraction; Aortic Aneurysm, Thoracic - surgery; Biological and medical sciences; Blood and lymphatic vessels; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - adverse effects; Blood Vessel Prosthesis Implantation - instrumentation; Cardiology. Vascular system; Catheters; Diseases of the aorta; Endovascular Procedures - adverse effects; Endovascular Procedures - instrumentation; Equipment Design; Humans; Male; Medical sciences; Middle Aged; Prosthesis Design; Renal Artery Obstruction - diagnostic imaging; Renal Artery Obstruction - etiology; Renal Artery Obstruction - therapy; Reoperation; Robotics - instrumentation; Stents; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Therapy, Computer-Assisted - instrumentation; Tomography, X-Ray Computed; Treatment Outcome; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Catheter; Aorta; Cardiovascular disease; Endovascular route; Surgery
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2011.07.032

We report the use of a remotely steerable catheter to treat kinked renal bridging stents 8 months after branched endovascular repair of a type III thoracoabdominal aortic aneurysm. Conventional techniques using single, coaxial, and manually steerable sheaths proved too unstable to provide the support required to pass a wire against resistance through the kinked stent. A remotely steerable “robotic” catheter provided sufficient precision and stability to cross the kink and reline it with an additional stent, restoring renal perfusion. This technology can help achieve precise and stable introducer sheath position. Further evaluation is necessary to understand the wider applications.