1
|
Zhang C, Guo S, Xiao N, Wu J, Li Y, Jiang Y. Transverse microvibrations-based guide wires drag reduction evaluation for endovascular interventional application. Biomed Microdevices 2018; 20:69. [PMID: 30094504 DOI: 10.1007/s10544-018-0315-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
When conducting endovascular interventional surgery, doctors usually experience high viscous resistance resulting from direct contact with blood when operating the guide wire in blood vessels, which reduces the operational efficiency. Improper operation can cause vascular injuries and greatly reduce surgical safety, sometimes leading to the death of the patient. This paper presents a new method that applies transverse microvibrations at the proximal end of a conventional passive guide wire to reduce viscous resistance. The effect of the proposed method in reducing the viscous resistance in the fluid is studied. The influences of the tube diameter, medium density, and applied vibration frequency on the viscous force are investigated. Finally, for endovascular therapy, a mathematical model of the viscous force of the guide wire based on the proposed method is established in the environment of human blood vessels to predict the magnitude of the viscous force exerted on the guide wire and analyze the drag reduction effect of the proposed method. The effectiveness of the proposed method in drag reduction and its feasibility in improving surgical safety are experimentally demonstrated. The experimental results indicate that the proposed method can assist the doctor during complicated and variable operation conditions.
Collapse
Affiliation(s)
- Chaonan Zhang
- Key Laboratory of Convergence Medical Engineering System and Healthcare Technology, Ministry of Industry and Information Technology, Beijing Institute of Technology, Beijing, 100081, China
| | - Shuxiang Guo
- Key Laboratory of Convergence Medical Engineering System and Healthcare Technology, Ministry of Industry and Information Technology, Beijing Institute of Technology, Beijing, 100081, China. .,Intelligent Mechanical Systems Engineering Department, Kagawa University, Takamatsu, 761-0396, Japan.
| | - Nan Xiao
- Key Laboratory of Convergence Medical Engineering System and Healthcare Technology, Ministry of Industry and Information Technology, Beijing Institute of Technology, Beijing, 100081, China.
| | - Jiaqing Wu
- Key Laboratory of Convergence Medical Engineering System and Healthcare Technology, Ministry of Industry and Information Technology, Beijing Institute of Technology, Beijing, 100081, China
| | - Youxiang Li
- Department of Interventional Neuroradiology, Beijing Engineering Technology Research Center for Interventional Neuroradiology, and Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, 10050, China
| | - Yuhua Jiang
- Department of Interventional Neuroradiology, Beijing Engineering Technology Research Center for Interventional Neuroradiology, and Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, 10050, China
| |
Collapse
|
2
|
Percutaneous intentional intra-luminal-assisted recanalization (PILAR technique) of challenging chronic total occlusions using a high-frequency vibration device. Eur Radiol 2018; 28:4792-4799. [DOI: 10.1007/s00330-018-5479-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 04/02/2018] [Accepted: 04/11/2018] [Indexed: 10/16/2022]
|
3
|
Bhatt H, Janzer S, George JC. Crossing techniques and devices in femoropopliteal chronic total occlusion intervention. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2017; 18:623-631. [DOI: 10.1016/j.carrev.2017.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 05/31/2017] [Accepted: 06/02/2017] [Indexed: 10/19/2022]
|
4
|
Sakes A, Regar E, Dankelman J, Breedveld P. Crossing Total Occlusions: Navigating Towards Recanalization. Cardiovasc Eng Technol 2016; 7:103-17. [PMID: 26831298 PMCID: PMC4858560 DOI: 10.1007/s13239-016-0255-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 01/12/2016] [Indexed: 11/07/2022]
Abstract
Chronic total occlusions (CTOs) represent the "last frontier" of percutaneous interventions. The main technical challenges lies in crossing the guidewire into the distal true lumen, which is primarily due to three problems: device buckling during initial puncture, inadequate visualization, and the inability to actively navigate through the CTO. To improve the success rate and to identify future research pathways, this study systematically reviews the state-of-the-art of all existing and invented devices for crossing occlusions. The literature search was executed in the databases of Scopus and Espacenet using medical and instrument-related keyword combinations. The search yielded over 840 patents and 69 articles. After scanning for relevancy, 45 patents and 16 articles were included. The identified crossing devices were subdivided based on the determinant for the crossing path through the occlusion, which is either the device (straight and angled crossing), the environment (least resistance, tissue selective, centerline, and subintimal crossing) or the user (directly steered and sensor enhanced crossing). It was found that each crossing path is characterized by specific advantages and disadvantages. For a future crossing device, a combination of crossing paths is suggested were the interventionist is able to exert high forces on the CTO (as seen in the device approach) and actively steer through the CTO (user: directly steered crossing) aided by intravascular imaging (user: sensor enhanced crossing) or an intrinsically safe device following the centerline or path of least resistance (environment: centerline crossing or least resistance crossing) to reach the distal true lumen.
Collapse
Affiliation(s)
- Aimée Sakes
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands.
| | - Evelyn Regar
- Department of Biomedical Engineering, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jenny Dankelman
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands
| | - Paul Breedveld
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands
| |
Collapse
|
5
|
Sakes A, Regar E, Dankelman J, Breedveld P. Treating Total Occlusions: Applying Force for Recanalization. IEEE Rev Biomed Eng 2016; 9:192-207. [DOI: 10.1109/rbme.2016.2580218] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
6
|
Zander T, Gonzalez G, De Alba L, Rivero O, Maynar M. Transcollateral Approach for Percutaneous Revascularization of Complex Superficial Femoral Artery and Tibioperoneal Trunk Occlusions. J Vasc Interv Radiol 2012; 23:691-5. [DOI: 10.1016/j.jvir.2012.01.074] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 01/13/2012] [Accepted: 01/16/2012] [Indexed: 10/28/2022] Open
|