Electroanatomical Navigation to Minimize Contrast Medium or X-Rays During Stenting: Insights From an Experimental Model.
JACC Basic Transl Sci 2022;
7:131-142. [PMID:
35257040 PMCID:
PMC8897164 DOI:
10.1016/j.jacbts.2021.11.001]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 12/05/2022]
Abstract
Contrast media and x-rays used in vascular interventional procedures have been linked to health hazards for patients and medical teams.
Modified OCT and angioplasty catheters were successful navigated in coronary and carotid arteries using an impedance-sensitive navigation system and used to precisely deliver and implant stents in specified arterial targets without the need for x-ray or contrast medium. Our system achieved an accuracy of 90% and a precision of 1.4mm.
This proof-of-principle experiment opens the door to PCI with no contrast medium or X-ray in human through the integration of coronary CT scan and intracoronary imaging technologies within navigation systems.
Stents can be effectively implemented with no x-rays or contrast medium. Modified stents were successfully implanted in 9 of 11 attempted targets (82%) (7 carotid and 4 coronary arteries) using an impedance-sensitive navigation system and optical coherence tomography. Electroanatomical navigation systems can be used to assist interventionalists in performing arterial stenting while minimizing x-ray and contrast use, thereby potentially enhancing safety for both patients and catheterization laboratory staff members.
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