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Celia V. Riga, MRCS, Nicholas J. W. Cheshire, MD, Mohamad S

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Presentation on theme: "Celia V. Riga, MRCS, Nicholas J. W. Cheshire, MD, Mohamad S"— Presentation transcript:

1 The role of robotic endovascular catheters in fenestrated stent grafting 
Celia V. Riga, MRCS, Nicholas J.W. Cheshire, MD, Mohamad S. Hamady, FRCR, Colin D. Bicknell, MD  Journal of Vascular Surgery  Volume 51, Issue 4, Pages (April 2010) DOI: /j.jvs Copyright © Terms and Conditions

2 Fig 1 Fluoroscopic image of the pulsatile silicone phantom used in the study. The four-vessel fenestrated stent graft fixed in suspension at the level of the visceral aortic segment (52 mm) is also shown. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

3 Fig 2 The robotic workstation with the Instinctive Motion Controller (IMC) that remotely controls the robotic catheter. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

4 Fig 3 The Imperial College Complex Cannulation Scoring Tool (IC3ST). The minimum score for technical performance is 7, and 35 is the maximum attainable score. Operators were assessed on their ability to choose an appropriate catheter, the ability to recognize catheter unsuitability, use of their chosen catheter to its maximum advantage, and the ability to shape and torque the selected catheter with fine and controlled movements, as shown on the IC3ST scoring sheet. Embolization/dissection risk was assessed when looking at excessive force and multiple catheter tip draggings along the vessel wall and manipulation of the guiding catheter without support of a guide wire, especially in areas of embolic potential, such as the ostia of the target vessels. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

5 Fig 4 A, Bar chart representing whole procedure time (minutes) with conventional versus robotic catheters (x-axis). Median procedure times are shown on the y-axis. The error bars represent the interquartile ranges (Wilcoxon signed rank test). B, Line chart illustration of the data above showing reductions in median procedure time with the robotic system versus conventional techniques, for each individual operator. Each operator is represented as a marker on either side of the plot area. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

6 Fig 5 A, Bar chart representing whole procedure movements at the wire/catheter tip with conventional versus robotic catheters (x-axis). Median number of movements are shown on the y-axis. The error bars represent the interquartile ranges (Wilcoxon signed rank test). B, Line chart illustration of the data above showing reductions in median number of wire/catheter movements with the robotic system versus conventional techniques, for each individual operator. Each operator is represented as a marker on either side of the plot area. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

7 Fig 6 Robotic cannulation of the left renal artery.
Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

8 Fig 7 Robotic cannulation of the right renal artery.
Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

9 Fig 8 Robotic cannulation of the superior mesenteric artery.
Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

10 Fig 9 Bar chart representing median individual target vessel cannulation times with conventional versus robotic catheters. The error bars represent the interquartile ranges (Wilcoxon signed rank test). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

11 Fig 10 Bar chart representing the median number of wire/catheter tip movements for individual target vessel cannulation with conventional versus robotic catheters. The error bars represent the interquartile ranges (Wilcoxon signed rank test). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

12 Fig 11 Line chart representing individual operator performance scores on the IC3ST scale with conventional and robotic cannulation techniques (Wilcoxon signed rank test). Each operator is represented as a marker on either side of the plot area. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

13 Fig 12 Bar chart representing operator performance scores between Groups A, B, and C using conventional and robotic techniques (Wilcoxon signed rank test). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

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