VINE Catheter: Soft, Tip-extending, Robotic Catheters with Shape Control for Endovascular Surgery

VINE 导管：用于血管内手术的具有形状控制功能的柔软、尖端延伸的机器人导管

• 批准号: 10522892
• 负责人: Tania Kiyoye Morimoto
• 金额: $ 45.74万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10522892
• 关键词: Acute; Address; Anatomy; Aneurysm; Animal Model; Arteries; Autopsy; Behavior; Blood Substitutes; Blood Vessels; Blood coagulation; Brain Diseases; Caring; Catheterization; Catheters; Clinical; Complex; Coronary Arteriosclerosis; Data; Disease; Distal; Endothelium; Environment; Equipment; Exhibits; Face; Family suidae; Goals; Growth; Heart Diseases; Histologic; Inguinal region; Injury; Lead; Liquid substance; Liver diseases; Location; Manuals; Methods; Minimally Invasive Surgical Procedures; Modeling; Movement; Operative Surgical Procedures; Outcome; Patient imaging; Patients; Plants; Procedures; Public Health; Recovery; Research; Robotics; Rotation; Safety; Shapes; Side; Silicones; Specialist; Stroke; Structure; Surgeon; System; Techniques; Tendon structure; Testing; Thrombectomy; Time; Training; Travel; Vascular Diseases; Work; X-Ray Computed Tomography; arm; base; design; high risk; improved; improved outcome; in vivo; innovation; instrument; man; minimally invasive; mortality; older patient; operation; pressure; renal artery; robotic system; success; tool; vascular injury

PROJECT SUMMARY Endovascular surgeries (ES) increasingly augment or replace traditional open surgical treatment of brain, liver, heart, and vascular diseases due to their improved clinical outcomes, faster recovery times, and improved mor- tality rates. These surgeries are commonly performed by inserting endovascular equipment into the groin or arm and navigating to distal arteries through a combination of axial loading and rotation of the base of the tools, utilizing the curved tips to deflect into intended locations and vessels. Despite the many benefits of endovascular surgeries, vascular anatomy, particularly for elderly patients who represent a large portion of those undergoing such procedures, can demonstrate excessive tortuosity and severe angulation, leading to high-risk , time-intensive procedures that can only be performed by a select number of expertly trained specialists. The small number of specialists results in limited access to necessary treatment, and patients are forced to either wait and travel for treatment or to not receive treatment at all. There is therefore a critical need for new endovascular robotic surgical tools that are safe, e↵ective, and that enable more surgeons to successfully navigate challenging anatomies. To address this need, a new soft-robotic approach called VINE – Vascular Internal Navigation by Extension – will be used. When pressurized with fluid, these VINEs navigate via extension at their tip in a man- ner analogous to how plants grow, creating shapes with complex curvatures. These VINEs are inherently safer due to their soft structure and represent a fundamentally di↵erent method of movement. The overall objective of this work is to characterize the behavior and refine the design of the VINE for ES, including the shape control methods, and to validate its e"cacy and safety. The central hypothesis is that this new method of shape control and navigation via tip-extension enables VINEs to safely and e↵ectively traverse the vasculature. The central hypothesis will be tested by pursuing three specific aims: (1) characterize and refine small-scale, pre-shaped and steerable VINE designs for ES, (2) evaluate VINE e"cacy in bench-top models, and (3) validate the safety of the entire VINE system in an in vivo pig study. This work will serve as a first step towards achieving the long-term goal of creating a soft robotic catheterization system, operable by a large number of surgeons, to increase access to high-quality surgical treatment. This work is innovative in that the proposed VINE is the first everting, robotic catheter with shape control and represents a substantive departure from the status quo, which currently relies on pushing semi-rigid instruments from their proximal end. The expected contribution of this work is a preliminary soft, tip-extending robotic system capable of safely and e↵ectively navigating around acute turns and through winding paths of the vasculature, which is significant since it will ultimately lead to increased access to high-quality minimally invasive procedures.

项目摘要 血管内手术（ES）越来越增加或替代传统的大脑，肝脏，肝脏的开放手术治疗 由于其改善的临床结果，更快的恢复时间和改善的临床结果，心脏和血管疾病 省力率。这些手术通常是通过将血管内设备插入腹股沟或手臂来进行的 和通过轴向载荷和工具底座旋转的组合到远端动脉的导航， 使用弯曲的尖端转化为预期的位置和容器。尽管内血管内有很多好处 手术，血管解剖结构，特别是对于代表大部分接受的老年患者 这样的程序可以表现出过度的曲折和严重的角度，导致高风险，耗时 只能由精选培训的专家才能执行的程序。少量 专家的途径有限，无法获得必要的治疗，并且患者被迫等待和旅行 治疗或根本不接受治疗。因此，新的血管内机器人有迫切需要 安全，e显的手术工具，并使更多的外科医生能够成功地挑战解剖学。 为了满足这一需求，一种称为藤蔓 - 血管内部导航的新的软射击方法 扩展 - 将使用。当用流体加压时，这些葡萄藤通过延伸的延伸而导航 类似于植物的生长，形成了复杂的曲率。这些葡萄藤本质上是安全的 由于其软结构，并代表了一种基本不同的运动方法。总体目标 这项工作是为了表征行为并重新确定葡萄藤的设计，包括形状控制 方法，并验证其“审核和安全性。中心假设是这种新的形状控制方法 通过尖端扩张导航使葡萄藤能够安全地横穿脉管系统。中央 假设将通过追求三个特定目的来检验：（1）表征和重新定义小规模，预状态和 ES的可进入葡萄藤设计，（2）评估藤蔓型“基准模型中的Cacy”，（3）验证 体内猪研究中的整个藤蔓系统。这项工作将成为实现长期的第一步 创建一个可通过大量外科医生操作的软机器人导管系统的目标，以增加访问 进行高质量的手术治疗。 这项工作具有创新性，因为拟议的葡萄藤是具有形状控制和形状控制和 代表与现状的实质性不同，目前依赖于推动半刚性仪器 从他们的近端。这项工作的预期贡献是一个初步的软，延伸的机器人系统 能够安全和e显地在急性转弯和脉管系统的绕组路径上进行导航，该路径 这是显着的，因为它最终将导致获得高质量的最低侵入性程序的访问。