The Methodist Hospital, DeBakey Heart & Vascular Center, 6550 Fannin, Houston, TX 77030, USA.
J Endovasc Ther. 2011 Apr;18(2):243-9. doi: 10.1583/10-3324R.1.
To evaluate the feasibility and safety of a redesigned remotely operated vascular catheter versus manual catheter manipulation in a porcine model.
Following femoral artery puncture and wire insertion, 4 pigs had either a robotically steered catheter (3 animals) or standard manual catheter manipulation to cannulate the contralateral iliac artery, bilateral renal arteries, and the superior mesenteric artery. After harvesting, the vessels were evaluated histologically by an independent laboratory using hematoxylin and eosin staining. Each cannulated artery was assessed for disruption of the intimal surface, intimal thrombus, damage to the tunica muscularis (dissection), mural hemorrhage, and inflammation by a pathologist who was blinded to the technique utilized for cannulation.
No histological evidence of intimal thrombus, disruption, inflammation, or hemorrhage was demonstrated in any vessel section from the robotic cases. In the SMA, 1 of 61 sections from the robotic cases demonstrated mild focal dissection, while 1 of 9 slices from the manual control showed intimal thrombus. Of 129 slices from the renal arteries catheterized by the robotic system, 4 sections demonstrated mild focal dissection, while 2 of 23 sections from the manual control showed grade 1 intimal thrombus. In the iliofemoral arteries, 3 of 91 sections showed mild focal dissection in the robotic cases; in the manual control, 1 of 9 slices demonstrated extensive dissection and another showed mild intimal thrombus.
The robotically operated catheter was at least as safe as manual manipulation. More extensive injury was actually observed with the manual technique. This newly designed robotic catheter has the potential to offer many advantages in terms of flexibility and range of motion.
评估改良的远程操作血管导管与手动导管操作在猪模型中的可行性和安全性。
经股动脉穿刺并插入导丝后，4 只猪分别采用机器人引导导管（3 只动物）或标准手动导管操作，以将导管插入对侧髂动脉、双侧肾动脉和肠系膜上动脉。在采集后，由独立实验室使用苏木精和伊红染色对血管进行组织学评估。由一位对导管插入技术不了解的病理学家对每个被插管的动脉进行评估，评估内容包括内膜表面破裂、内膜血栓形成、血管平滑肌层（夹层）损伤、壁内出血和炎症。
机器人组的所有血管切片均未显示内膜血栓形成、破裂、炎症或出血的组织学证据。在 SMA 中，机器人组的 61 个切片中有 1 个显示轻度局灶性夹层，而手动对照组的 9 个切片中有 1 个显示内膜血栓形成。在机器人系统插管的 129 个肾动脉切片中，有 4 个切片显示轻度局灶性夹层，而手动对照组的 23 个切片中有 2 个显示 1 级内膜血栓形成。在髂股动脉中，机器人组的 91 个切片中有 3 个显示轻度局灶性夹层；在手动对照组中，1 个切片显示广泛的夹层，另 1 个切片显示轻度内膜血栓形成。
机器人操作导管至少与手动操作一样安全。实际上，手动技术观察到的损伤更为广泛。这种新设计的机器人导管具有在灵活性和运动范围方面提供许多优势的潜力。
