In vitro renal artery stenting using a steerable guide wire navigated by a mobile electromagnetic field.

Abstract

Objective Endovascular procedures require precise guide wire control that often requires auxiliary devices. Therefore, catheterization can be time- and resource-intensive. A novel technology involves using a mobile external electromagnetic field to manipulate guide wires remotely, eliminating the need for additional devices. This experimental study evaluates the feasibility of this technology in a representative three-dimensional model mimicking the human vasculature, comparing it with conventional means.Methods We assessed the efficacy of a magnetically steerable guide wire (MGW) vs a conventional guide wire (CGW) in catheterizing the renal artery in a three-dimensional silicone model of the abdominal aorta.Results A total of 20 procedures were performed, with 10 utilizing an MGW for renal artery catheterization and 10 using a CGW. Technical success was 100% for all procedures. The median procedure time was significantly shorter for MGW than for CGW (105 vs 181 seconds; P < .001). We observed a trend towards lower median fluoroscopic time (65 vs 101 seconds; P = .06) and lower median fluoroscopic dose (6.84 vs 10.98 mGycm2; P = .063) for MGW compared with CGW.Conclusions Precise control of a steerable guide wire using a mobile external electromagnetic field is technically feasible in a three-dimensional silicone model of the human aorta. It facilitates in vitro renal artery catheterization and stenting and reduces both procedure and fluoroscopy time. This novel technology could further improve numerous endovascular procedures.