Cargando…
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...
Autores principales: | , , , , , , |
---|---|
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 |
_version_ | 1783471148410863616 |
---|---|
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. |
format | Online Article Text |
id | pubmed-6859597 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT aliawaz cathetersteeringininterventionalcardiologymechanicalanalysisandnovelsolution AT sakesaimee cathetersteeringininterventionalcardiologymechanicalanalysisandnovelsolution AT arkenboutewouta cathetersteeringininterventionalcardiologymechanicalanalysisandnovelsolution AT henselmanspaul cathetersteeringininterventionalcardiologymechanicalanalysisandnovelsolution AT vanstarkenburgremi cathetersteeringininterventionalcardiologymechanicalanalysisandnovelsolution AT szilitoroktamas cathetersteeringininterventionalcardiologymechanicalanalysisandnovelsolution AT breedveldpaul cathetersteeringininterventionalcardiologymechanicalanalysisandnovelsolution |