Abstract No. 353 - Evaluation of robot-assisted catheterization using the Magellan system for embolization

Abstract

No. 353 Evaluation of robot-assisted catheterization using the Magellan system for embolization G. Rao, S. Rao; Medicine, University of North Texas Health Science Center, Fort Worth, TX; SierraProvidence Health Network, El Paso, TX Purpose: To evaluate the safety and efficacy of robot-assisted catheter guidance by the Magellan (Hansen Medical, Mountain View, California, USA) robotic catheter for embolization procedures. The following four procedures were evaluated: uterine fibroid embolization, transarterial chemoembolization with drug-eluting beads for hepatocellular carcinoma, embolization for gastric hemorrhage and embolization of pulmonary arteriovenous malformation. Materials and Methods: Four patients underwent embolization using the remotely controlled Magellan catheter system. Documented performance metrics and data include: fluoroscopy time, success of target vessel cannulation, procedural time, contrast use, and overall technical success. Robotic manipulation routes included femoral and radial arterial access and femoral venous access. Assessment included evaluation of embolization ability using a variety of embolic materials. Results: Technical success was 100%. No complications seen. For the four cases: 1) UFE: 6Fr robotic catheter successfully accessed contralateral anterior branch of the internal iliac and ostium of the ipsilateral internal iliac. Further distal cannulation achieved with microcatheter. 2) 6Fr catheter for DEBTACE demonstrated successful catheterization of the right hepatic artery. Distal branches required microcatheter placement. 3) 6Fr catheter via radial access demonstrated successful catheterization of the gastroepiploic artery for particle and coil embolization for gastric bleed. Left gastric artery was poorly visualized and not accessed. 4) 9Fr catheter usage for embolization of pulmonary arteriovenous malformation demonstrated adequate access into right lower lobe pulmonary branch. Distal catheterization of feeding vessel required microcatheter for coil embolization. Reduction in radiation exposure to the operator was over 70% compared to control radiation monitor at patient bedside. Conclusion: Technical success without complication can be achieved during embolization procedures with the robotic system. Distal subselective target embolization may require the use of manual cannulation using a separate microcatheter. Usage of the remotely controlled catheter reduces radiation exposure to the operator.