Flow-driven magnetic microcatheter for superselective arterial embolization

TL;DR

This paper introduces a novel magnetic microcatheter that is highly flexible and capable of navigating small, tortuous brain arteries using blood flow energy, enabling minimally invasive treatments previously inaccessible.

Contribution

It presents a new ultraminiaturized, inflatable magnetic microcatheter and a compatible steering platform, allowing safe navigation of tiny, complex arteries for the first time.

Findings

Successful navigation of arteries as small as 180 μm in diameter.

Effective superselective infusion of contrast and embolic agents in a pig model.

Potential to treat previously inaccessible distal arteries with improved safety.

Abstract

Minimally invasive interventions performed inside brain vessels with the synergistic use of microcatheters pushed over guidewires have revolutionized the way aneurysms, stroke, arteriovenous malformations, brain tumors and other cerebrovascular conditions are being treated. However, a significant portion of the brain vasculature remains inaccessible from within because the conventional catheterization technique based on transmitting forces from the proximal to the distal end of the instruments imposes stringent constraints on their diameter and stiffness. Here we overcome this mechanical barrier by microengineering a new class of ultraminiaturized magnetic microcatheters in the form of an inflatable flat tube, making them extremely flexible and capable of harnessing the kinetic energy of blood flow for endovascular navigation. We introduce a compact and versatile magnetic steering platform that is compatible with conventional bi-plane fluoroscope imaging, and demonstrate for the first time safe and effortless navigation and tracking of hard-to-reach, distal, tortuous arteries that are as small as 180 um in diameter with a curvature radius as small as 0.69 mm. Furthermore, we demonstrate the superselective infusion of contrast and embolic liquid agents, all in a porcine model. These results pave the way to reach, diagnose, and treat currently inaccessible distal arteries that may be at risk of bleeding or feeding a tumor. Our endovascular technology can also be used to selectively target tissues for drug or gene delivery from within the arteries, not only in the central and peripheral nervous system but almost any other organ system, with improved accuracy, speed and safety.