Cochennec Frédéric, Kobeiter Hicham, Gohel Manj, Marzelle Jean, Desgranges Pascal, Allaire Eric, Becquemin Jean Pierre
Henri Mondor Hospital, Créteil, France
Henri Mondor Hospital, Créteil, France.
J Endovasc Ther. 2015 Apr;22(2):187-93. doi: 10.1177/1526602815573228.
To evaluate the safety and success of target vessel cannulation in the visceral aortic segment using the Magellan robotic catheter system (RCS) during complex endovascular aortic procedures.
Robotic navigation was attempted for access to 37 target vessels in 15 patients (14 men; mean age 75±10 years) during 16 fenestrated and/or branched stent-grafting procedures and 1 endovascular repair requiring the chimney technique. For each target vessel, robotic navigation was attempted for a maximum of 15 minutes; if cannulation was unsuccessful in that time, manual catheters were employed. Safety was evaluated by recording intraoperative adverse events, intraoperative complications related to robotic navigation, and postoperative complications. Technical success of robotic cannulation, wire cannulation times, and times for inserting the leader over the wire in the target vessels were recorded to assess RCS performance.
Successful robotic cannulation was achieved for 30 (81%) of the 37 target vessels, with a median wire cannulation time of 263 seconds (range 40-780) and a median 15 seconds (range 5-450) for inserting the leader over the wire. No intraoperative complications related to robotic navigation were observed. Seven of 27 arteries accessed via 7 fenestrations could not be cannulated within 15 minutes; all were cannulated successfully using conventional catheters (mean cannulation time 31±7 minutes). All 10 target vessels accessed via branches and chimney stents were successfully cannulated with the RCS.
Cannulation of target vessels with the RCS during complex endovascular aortic procedures is feasible and safe. The robotic system was particularly effective for branched and chimney stents.
评估在复杂的血管内主动脉手术中，使用麦哲伦机器人导管系统（RCS）对内脏主动脉段目标血管进行插管的安全性和成功率。
在16例开窗和/或分支支架植入手术以及1例需要烟囱技术的血管内修复手术中，尝试使用机器人导航对15例患者（14名男性；平均年龄75±10岁）的37条目标血管进行插管。对于每条目标血管，机器人导航尝试时间最长为15分钟；如果在该时间内插管未成功，则使用手动导管。通过记录术中不良事件、与机器人导航相关的术中并发症以及术后并发症来评估安全性。记录机器人插管的技术成功率、导丝插管时间以及在目标血管中沿导丝插入引导器的时间，以评估RCS的性能。
37条目标血管中有30条（81%）成功进行了机器人插管，导丝插管时间中位数为263秒（范围40 - 780秒），沿导丝插入引导器的时间中位数为15秒（范围5 - 450秒）。未观察到与机器人导航相关的术中并发症。通过7个开窗进入的27条动脉中有7条在15分钟内未能插管成功；使用传统导管均成功插管（平均插管时间31±7分钟）。通过分支和烟囱支架进入的所有10条目标血管均使用RCS成功插管。
在复杂的血管内主动脉手术中，使用RCS对目标血管进行插管是可行且安全的。机器人系统在分支和烟囱支架方面特别有效。
