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Catheter steering in interventional cardiology: Mechanical analysis and novel solution

In recent years, steerable catheters have been developed to combat the effects of the dynamic cardiac environment. Mechanically actuated steerable catheters appear the most in the clinical setting; however, they are bound to a number of mechanical limitations. The aim of this research is to gain ins...

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Autores principales: Ali, Awaz, Sakes, Aimee, Arkenbout, Ewout A, Henselmans, Paul, van Starkenburg, Remi, Szili-Torok, Tamas, Breedveld, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859597/
https://www.ncbi.nlm.nih.gov/pubmed/31580205
http://dx.doi.org/10.1177/0954411919877709
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author Ali, Awaz
Sakes, Aimee
Arkenbout, Ewout A
Henselmans, Paul
van Starkenburg, Remi
Szili-Torok, Tamas
Breedveld, Paul
author_facet Ali, Awaz
Sakes, Aimee
Arkenbout, Ewout A
Henselmans, Paul
van Starkenburg, Remi
Szili-Torok, Tamas
Breedveld, Paul
author_sort Ali, Awaz
collection PubMed
description In recent years, steerable catheters have been developed to combat the effects of the dynamic cardiac environment. Mechanically actuated steerable catheters appear the most in the clinical setting; however, they are bound to a number of mechanical limitations. The aim of this research is to gain insight in these limitations and use this information to develop a new prototype of a catheter with increased steerability. The main limitations in mechanically steerable catheters are identified and analysed, after which requirements and solutions are defined to design a multi-steerable catheter. Finally, a prototype is built and a proof-of-concept test is carried out to analyse the steering functions. The mechanical analysis results in the identification of five limitations: (1) low torsion, (2) shaft shortening, (3) high unpredictable friction, (4) coupled tip-shaft movements, and (5) complex cardiac environment. Solutions are found to each of the limitations and result in the design of a novel multi-steerable catheter with four degrees of freedom. A prototype is developed which allows the dual-segmented tip to be steered over multiple planes and in multiple directions, allowing a range of complex motions including S-shaped curves and circular movements. A detailed analysis of limitations underlying mechanically steerable catheters has led to a new design for a multi-steerable catheter for complex cardiac interventions. The four integrated degrees of freedom provide a high variability of tip directions, and repetition of the bending angle is relatively simple and reliable. The ability to steer inside the heart with a variety of complex shaped curves may potentially change conventional approaches in interventional cardiology towards more patient-specific and lower complexity procedures. Future directions are headed towards further design optimizations and the experimental validation of the prototype.
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spelling pubmed-68595972019-12-12 Catheter steering in interventional cardiology: Mechanical analysis and novel solution Ali, Awaz Sakes, Aimee Arkenbout, Ewout A Henselmans, Paul van Starkenburg, Remi Szili-Torok, Tamas Breedveld, Paul Proc Inst Mech Eng H Original Articles In recent years, steerable catheters have been developed to combat the effects of the dynamic cardiac environment. Mechanically actuated steerable catheters appear the most in the clinical setting; however, they are bound to a number of mechanical limitations. The aim of this research is to gain insight in these limitations and use this information to develop a new prototype of a catheter with increased steerability. The main limitations in mechanically steerable catheters are identified and analysed, after which requirements and solutions are defined to design a multi-steerable catheter. Finally, a prototype is built and a proof-of-concept test is carried out to analyse the steering functions. The mechanical analysis results in the identification of five limitations: (1) low torsion, (2) shaft shortening, (3) high unpredictable friction, (4) coupled tip-shaft movements, and (5) complex cardiac environment. Solutions are found to each of the limitations and result in the design of a novel multi-steerable catheter with four degrees of freedom. A prototype is developed which allows the dual-segmented tip to be steered over multiple planes and in multiple directions, allowing a range of complex motions including S-shaped curves and circular movements. A detailed analysis of limitations underlying mechanically steerable catheters has led to a new design for a multi-steerable catheter for complex cardiac interventions. The four integrated degrees of freedom provide a high variability of tip directions, and repetition of the bending angle is relatively simple and reliable. The ability to steer inside the heart with a variety of complex shaped curves may potentially change conventional approaches in interventional cardiology towards more patient-specific and lower complexity procedures. Future directions are headed towards further design optimizations and the experimental validation of the prototype. SAGE Publications 2019-10-03 2019-12 /pmc/articles/PMC6859597/ /pubmed/31580205 http://dx.doi.org/10.1177/0954411919877709 Text en © IMechE 2019 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Ali, Awaz
Sakes, Aimee
Arkenbout, Ewout A
Henselmans, Paul
van Starkenburg, Remi
Szili-Torok, Tamas
Breedveld, Paul
Catheter steering in interventional cardiology: Mechanical analysis and novel solution
title Catheter steering in interventional cardiology: Mechanical analysis and novel solution
title_full Catheter steering in interventional cardiology: Mechanical analysis and novel solution
title_fullStr Catheter steering in interventional cardiology: Mechanical analysis and novel solution
title_full_unstemmed Catheter steering in interventional cardiology: Mechanical analysis and novel solution
title_short Catheter steering in interventional cardiology: Mechanical analysis and novel solution
title_sort catheter steering in interventional cardiology: mechanical analysis and novel solution
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859597/
https://www.ncbi.nlm.nih.gov/pubmed/31580205
http://dx.doi.org/10.1177/0954411919877709
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