Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla, CA, USA.
School of Medicine, University of California San Diego, La Jolla, CA, USA.
Sci Robot. 2021 Aug 18;6(57). doi: 10.1126/scirobotics.abf0601.
Catheters used for endovascular navigation in interventional procedures lack dexterity at the distal tip. Neurointerventionists, in particular, encounter challenges in up to 25% of aneurysm cases largely due to the inability to steer and navigate the tip of the microcatheters through tortuous vasculature to access aneurysms. We overcome this problem with submillimeter diameter, hydraulically actuated hyperelastic polymer devices at the distal tip of microcatheters to enable active steerability. Controlled by hand, the devices offer complete 3D orientation of the tip. Using saline as a working fluid, we demonstrate guidewire-free navigation, access, and coil deployment in vivo, offering safety, ease of use, and design flexibility absent in other approaches to endovascular intervention. We demonstrate the ability of our device to navigate through vessels and to deliver embolization coils to the cerebral vessels in a live porcine model. This indicates the potential for microhydraulic soft robotics to solve difficult access and treatment problems in endovascular intervention.
在介入手术中用于血管内导航的导管在远端尖端缺乏灵活性。神经介入医师在多达 25%的动脉瘤病例中遇到挑战,主要是因为无法通过弯曲的脉管系统引导和导航微导管的尖端以到达动脉瘤。我们通过在微导管的远端尖端使用亚毫米直径的液压致动超弹性聚合物装置来克服这个问题,从而实现主动可控性。该装置通过手动控制,可提供尖端的完全 3D 定向。使用盐水作为工作流体,我们展示了体内无导丝导航、进入和线圈部署,提供了其他血管内介入方法所缺乏的安全性、易用性和设计灵活性。我们展示了我们的设备能够在活体猪模型中穿过血管并将栓塞线圈输送到脑血管的能力。这表明微液压软机器人有可能解决血管内介入治疗中的困难进入和治疗问题。