Burning Bridges

Roy, Trisha; Forbes, Thomas L.; Wright, Graham A.

doi:10.1177/1526602815604465

Cited by 12 publications

(5 citation statements)

References 53 publications

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“…The preclinical studies also showed that there were no visible signs of damage to the vessel wall, and there were no signs of coagulation on the device. These results demonstrate the potential of the CathPilot concept to reduce failure rates and complication rates [26]- [30], while reducing radiation exposure of all involved parties [31].…”

Section: Discussionmentioning

confidence: 65%

The CathPilot: Performance Validation and Preclinical Safety and Feasibility Assessment

Zhou

Alawneh

Sewani

et al. 2023

IEEE Trans. Biomed. Eng.

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Peripheral endovascular revascularization procedures often fail due to technical limitations of guidewire support, steering, and visualization. The novel CathPilot catheter aims to address these challenges. This study assesses the safety and feasibility of the CathPilot and compares its performance to conventional catheters for peripheral vascular interventions. Methods: The study compared the CathPilot to non-steerable and steerable catheters. The success rates and access times for a relevant target inside a tortuous vessel phantom model were assessed. The reachable workspace within the vessel and the guidewire's force delivery capabilities were also evaluated. To validate the technology, chronic total occlusion tissue samples were used ex vivo to compare crossing success rates with conventional catheters. Finally, in vivo experiments in a porcine aorta were conducted to evaluate safety and feasibility. Results: The success rates for reaching the set targets were 31%, 69%, and 100% with the non-steerable catheter, the steerable catheter, and the CathPilot, respectively. CathPilot had a significantly larger reachable workspace, and allowed for up to four times higher force delivery and pushability. In crossing of chronic total occlusion samples, the CathPilot achieved a success rate of 83% and 100%, for fresh and fixed lesions respectively, which was also significantly higher than conventional catheters. The device was fully functional in the in vivo study, and there were no signs of coagulation or damage to the vessel wall. Conclusion:This study shows the safety and feasibility of the CathPilot system and its potential to reduce failure and complication rates in peripheral vascular interventions. The novel catheter outperformed conventional catheters in all defined metrics. This technology can potentially improve the success rate and outcome of peripheral endovascular revascularization procedures.

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Section: Discussionmentioning

confidence: 65%

The CathPilot: Performance Validation and Preclinical Safety and Feasibility Assessment

Zhou

Alawneh

Sewani

et al. 2023

IEEE Trans. Biomed. Eng.

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“…Standard clinical vascular imaging methods, such as computed tomographic angiography (CTA) or ultrasound, are currently limited in visualizing tissue components of PAD lesions mostly due to limitations in soft tissue contrast beyond the presence of calcium and the presence of stenosis [52][53][54]. MRI is unique in its capability of adjusting soft tissue contrast for atherosclerotic lesions and therefore the ideal methodology for this task [3,11,[55][56][57][58]. Commonly used AI algorithms such as VAEs possess the advantage of quick and automated classification, once a particular algorithm has been properly trained.…”

Section: Discussionmentioning

confidence: 99%

Automatic Classification of Magnetic Resonance Histology of Peripheral Arterial Chronic Total Occlusions Using a Variational Autoencoder: A Feasibility Study

Csore,

Karmonik,

Wilhoit

et al. 2023

Diagnostics

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The novel approach of our study consists in adapting and in evaluating a custom-made variational autoencoder (VAE) using two-dimensional (2D) convolutional neural networks (CNNs) on magnetic resonance imaging (MRI) images for differentiate soft vs. hard plaque components in peripheral arterial disease (PAD). Five amputated lower extremities were imaged at a clinical ultra-high field 7 Tesla MRI. Ultrashort echo time (UTE), T1-weighted (T1w) and T2-weighted (T2w) datasets were acquired. Multiplanar reconstruction (MPR) images were obtained from one lesion per limb. Images were aligned to each other and pseudo-color red-green-blue images were created. Four areas in latent space were defined corresponding to the sorted images reconstructed by the VAE. Images were classified from their position in latent space and scored using tissue score (TS) as following: (1) lumen patent, TS:0; (2) partially patent, TS:1; (3) mostly occluded with soft tissue, TS:3; (4) mostly occluded with hard tissue, TS:5. Average and relative percentage of TS was calculated per lesion defined as the sum of the tissue score for each image divided by the total number of images. In total, 2390 MPR reconstructed images were included in the analysis. Relative percentage of average tissue score varied from only patent (lesion #1) to presence of all four classes. Lesions #2, #3 and #5 were classified to contain tissues except mostly occluded with hard tissue while lesion #4 contained all (ranges (I): 0.2–100%, (II): 46.3–75.9%, (III): 18–33.5%, (IV): 20%). Training the VAE was successful as images with soft/hard tissues in PAD lesions were satisfactory separated in latent space. Using VAE may assist in rapid classification of MRI histology images acquired in a clinical setup for facilitating endovascular procedures.

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“…We believe the control and feedback accuracy provided by the CathPilot is sufficient for cardiovascular catheter-based interventions and that our system helps to overcome the fundamental limitations associated with conventional manually steered devices. shown to contribute to complications [25], [31], [65]- [68]. With the tracking GUI, users know the instantaneous and former positions of the catheter tip, and time can be saved by avoiding incorrect or unsuccessful locations or trying to access a previous position.…”

Section: X-cadpam Systemmentioning

confidence: 99%

The CathPilot: A Novel Approach for Accurate Interventional Device Steering and Tracking

Zhou

2023

Preprint

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<p>Accurate catheter navigation is a significant challenge for minimally invasive catheter-based procedures. The catheter’s long length, high flexibility, mechanical interactions with the tortuous anatomy, and inadequate feedback from 2D projection x-ray limit accurate catheter tip control. This thesis describes the design, development, and evaluation of a novel catheter navigation system that directly addresses the fundamental limitations of conventional devices. We designed and developed a novel expandable frame and manual steering system using principles from cable-driven parallel manipulators to provide accurate, reliable, and localized control and feedback of the catheter tip position. The device’s performance under different tortuosity conditions and different expansion sizes were assessed, showing complete workspace coverage with localized steering within the frame and position tracking with submillimetre accuracy (~0.38mm) irrespective of the expansion size and path tortuosity. With the added control and feedback, the CathPilot promises to overcome the limitations of conventional catheter navigation and will allow for the next generation of interventional devices.</p>

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Burning Bridges

Cited by 12 publications

References 53 publications

The CathPilot: Performance Validation and Preclinical Safety and Feasibility Assessment

The CathPilot: Performance Validation and Preclinical Safety and Feasibility Assessment

Automatic Classification of Magnetic Resonance Histology of Peripheral Arterial Chronic Total Occlusions Using a Variational Autoencoder: A Feasibility Study

The CathPilot: A Novel Approach for Accurate Interventional Device Steering and Tracking

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