Ryu Jajun, Ahn Jung Hwan, Kim Hwa Young, Ahn Hyo Yeong
School of Mechanical Engineering, Pusan National University, Busan, South Korea.
Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Medical Research Institution, Busan, South Korea.
Ann Transl Med. 2020 Mar;8(5):169. doi: 10.21037/atm.2020.02.22.
Steering a catheter tip to a defective spot on a lung during fibrin glue application under pleurography (FGAP) constitutes a very challenging task. Accurate control of tip position/slope of steerable catheters is critical for providing glue to air-leaking defects on lung during FGAP. Steerable catheters are composed of multiple segments with different flexural rigidities and experience nonlinear deformation. Therefore, predicting tip position with accuracy is difficult. The purpose of this paper is to present a novel method that can accurately control the tip of the catheter, and thus enhance its target accessibility.
The tip position of a deflected steerable catheter can be accurately predicted using a simulation tool depicting the curvature of a bent catheter based on a mechanics of materials analysis. The proposed method utilizes the simulation tool to enhance the target accessibility of the catheter's tip. This assists medical doctors to not only select the optimal catheter prior to operation, but also to steer the catheter to the defects effectively. Simulation reliability is tested by performing a catheter deflection experiment and measuring the tip position.
The simulation result accurately predicts the location of the catheter tip with an error of less than 5 mm to the experimental results.
Controlling pull-wire tensions and overhang lengths based on simulation results substantially improves the target accessibility of the catheter tip.
在胸膜造影引导下应用纤维蛋白胶（FGAP）期间，将导管尖端引导至肺部的缺陷部位是一项极具挑战性的任务。在FGAP期间，精确控制可操纵导管的尖端位置/倾斜度对于向肺部漏气缺陷处提供胶水至关重要。可操纵导管由多个具有不同弯曲刚度的节段组成，并经历非线性变形。因此，准确预测尖端位置很困难。本文的目的是提出一种能够精确控制导管尖端的新方法，从而提高其到达目标的能力。
基于材料力学分析，使用描述弯曲导管曲率的模拟工具可以准确预测偏转可操纵导管的尖端位置。所提出的方法利用该模拟工具来提高导管尖端到达目标的能力。这有助于医生不仅在手术前选择最佳导管，而且能有效地将导管引导至缺陷处。通过进行导管偏转实验并测量尖端位置来测试模拟的可靠性。
模拟结果准确预测了导管尖端的位置，与实验结果的误差小于5毫米。
基于模拟结果控制拉线张力和悬垂长度可显著提高导管尖端到达目标的能力。
