Robot-assisted antegrade in-situ fenestrated stent grafting

Cardiovasc Intervent Radiol. 2009 May;32(3):522-4. doi: 10.1007/s00270-008-9459-5. Epub 2008 Oct 30.

Abstract

To determine the technical feasibility of a novel approach of in-situ fenestration of aortic stent grafts by using a remotely controlled robotic steerable catheter system in the porcine model. A 65-kg pig underwent robot-assisted bilateral antegrade in-situ renal fenestration of an abdominal aortic stent graft with subsequent successful deployment of a bare metal stent into the right renal artery. A 16-mm iliac extension covered stent served as the porcine aortic endograft. Under fluoroscopic guidance, the graft was punctured with a 20-G customized diathermy needle that was introduced and kept in place by the robotic arm. The needle was exchanged for a 4 x 20 mm cutting balloon before successful deployment of the renal stent. Robot-assisted antegrade in-situ fenestration is technically feasible in a large mammalian model. The robotic system enables precise manipulation, stable positioning, and minimum instrumentation of the aorta and its branches while minimizing radiation exposure.

MeSH terms

  • Angiography
  • Animals
  • Aorta, Abdominal / diagnostic imaging
  • Aorta, Abdominal / surgery*
  • Blood Vessel Prosthesis Implantation / methods*
  • Blood Vessel Prosthesis*
  • Feasibility Studies
  • Robotics*
  • Stents*
  • Swine