Reduced Radiation and 3D Navigation: A Phantom Study on Aortic Side Branch Cannulation Using a Shape-Sensed Guidewire
3D Guidance with Shape Sensing Reduces Radiation Exposure
This study evaluates a shape-sensed guidewire system that enables three-dimensional vascular navigation while minimizing radiation exposure during interventional procedures. Using an anatomically accurate aortic phantom model, we compared the performance of a prototype shape-sensed guidewire (0.035” diameter) system against traditional fluoroscopy-guided navigation. The system achieved successful vessel cannulation with zero radiation exposure beyond initial registration, compared to continuous fluoroscopy requirements in conventional approaches. Cannulation times were on average longer than under traditional two-dimensional guidance, however, this is attributed to the anatomy being clearly and continuously visible in the x-ray images without the use of contrast dye. The notable reduction of radiation exposure during navigation, combined with precise 3D visualization demonstrates this technology’s potential for improving procedural safety in minimally invasive procedures.
Introduction
Interventional radiology has revolutionized the treatment of vascular pathologies through minimally invasive procedures that reduce patient recovery times. However, traditional methods rely heavily on fluoroscopy, which poses significant challenges due to radiation exposure risks and the limitations of two-dimensional (2D) imaging. These challenges are particularly pronounced in procedures involving complex vascular structures, where 2D projection views can limit the level of detail required for precise guidance.
In conventional interventional procedures, clinicians inject contrast dye to visualize anatomical landmarks during live fluoroscopy, aiding in device navigation. However, because contrast dye is flushed out with the blood flow, clinicians must inject repeatedly to maintain anatomical visualization, interrupting procedural flow and exposing patients to additional risks. Additionally, repeated exposure to x-ray radiation poses significant health risks to medical staff, particularly during complex, lengthy procedures like fenestrated or branched endovascular aneurysm repairs (FEVAR or BEVAR). Addressing these limitations requires developing a navigation technology that provides continuous, radiation-free anatomical visualization while maintaining precise guidance.
This study demonstrates the feasibility and clinical advantages of using a shape-sensed guidewire…
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