Biologically Inspired Catheter for Endovascular Sensing and Navigation

Erin E Sutton,Bernhard Fuerst,Nassir Navab,Noah J Cowan,Reza Ghotbi

doi:10.1038/s41598-020-62360-w

Erin E Sutton, Bernhard Fuerst + Show 3 more

Open Access

https://doi.org/10.1038/s41598-020-62360-w

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Abstract

Minimally invasive treatment of vascular disease demands dynamic navigation through complex blood vessel pathways and accurate placement of an interventional device, which has resulted in increased reliance on fluoroscopic guidance and commensurate radiation exposure to the patient and staff. Here we introduce a guidance system inspired by electric fish that incorporates measurements from a newly designed electrogenic sensory catheter with preoperative imaging to provide continuous feedback to guide vascular procedures without additional contrast injection, radiation, image registration, or external tracking. Electrodes near the catheter tip simultaneously create a weak electric field and measure the impedance, which changes with the internal geometry of the vessel as the catheter advances through the vasculature. The impedance time series is then mapped to a preoperative vessel model to determine the relative position of the catheter within the vessel tree. We present navigation in a synthetic vessel tree based on our mapping technique. Experiments in a porcine model demonstrated the sensor’s ability to detect cross-sectional area variation in vivo. These initial results demonstrate the capability and potential of this novel bioimpedance-based navigation technology as a non-fluoroscopic technique to augment existing imaging methods.

Highlights

The number of vascular procedures performed under fluoroscopic guidance is increasing as minimally invasive techniques are developed for the diagnosis and treatment of a widening array of vascular diseases[1,2]
Pre-interventional imaging such as computed tomography angiography (CTA) and magnetic resonance imaging are commonly used for diagnosis of vascular disease such as aneurysms or blockages, and registration techniques attempt to leverage the rich 3D model to
We introduce a technique inspired by electric fish that incorporates measurements from a newly designed electrogenic sensory catheter with preoperative imaging to provide continuous feedback during vascular procedures without additional ionizing radiation, contrast injection, image registration, or external tracking

Summary

Introduction

The number of vascular procedures performed under fluoroscopic guidance is increasing as minimally invasive techniques are developed for the diagnosis and treatment of a widening array of vascular diseases[1,2]. There are existing techniques to reduce radiation use during endovascular procedures Systems such as CARTO 3 (Biosense Webster, Diamond Bar, CA) and Rhythmia (Boston Scientific, Marlborough, MA) employ external electromagnetic or external electric sources on the outside of the body to localize catheters in the cardiac chamber. Pre-interventional imaging such as computed tomography angiography (CTA) and magnetic resonance imaging are commonly used for diagnosis of vascular disease such as aneurysms or blockages, and registration techniques attempt to leverage the rich 3D model to enhance the 2D interventional image These techniques exhibit substantial error caused by unavoidable vessel deformation as devices are inserted and manipulated[16,18]. A simplified model of the impedance in a cylindrical vessel is: ZT

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