SideEye: A Side-Looking Catheter for Fenestrated Endovascular Aneurysm Repair Procedures

TL;DR

The SideEye catheter significantly improves target vessel cannulation efficiency and reduces radiation exposure during fenestrated endovascular aneurysm repair compared to conventional catheters, especially in misaligned cases.

Contribution

This paper introduces the novel SideEye steerable catheter and demonstrates its superior performance over traditional devices in a phantom model for complex aneurysm repairs.

Findings

SideEye reduced cannulation times by over 50% in misaligned cases.

SideEye decreased fluoroscopy exposure time by approximately 70%.

Performance improvements were statistically significant compared to conventional catheters.

Abstract

Fenestrated endovascular aneurysm repair remains a technically challenging procedure in the presence of complex anatomy, as it increases the difficulty of target vessel cannulation and prolongs procedure time and fluoroscopy radiation exposure. This paper aims to design, develop, and assess a novel steerable catheter, the SideEye, and compare its performance with conventional catheters in a thoracoabdominal aortic aneurysm phantom model. Users were asked to perform target vessel cannulation under fluoroscopic guidance using the SideEye and conventional non-steerable and steerable catheters. The experiment was divided into two cases based on the stent graft orientation (aligned and misaligned). Total procedure times, individual target vessel cannulation times, and exposure times were analyzed and compared in each case. In the misaligned case, the average cannulation times of all target vessels were $703 \pm 274$ s using the non-steerable catheter, $517 \pm 309$ s using the steerable catheter, and $199 \pm 91.0$ s using the SideEye. The average exposure times were $12 \pm 4.6$ min using the non-steerable catheter, $8.6 \pm 4.1$ min using the steerable catheter, and $3.0 \pm 1.1$ min using the SideEye. Target vessel cannulation using the SideEye significantly reduced procedure time and overall exposure time, compared to conventional devices.