Design of a sensorized guiding catheter for in situ laser fenestration of endovascular stent

@article{Piazza2017DesignOA,
  title={Design of a sensorized guiding catheter for in situ laser fenestration of endovascular stent},
  author={Roberta Piazza and Sara Condino and Aldo Alberti and Raffaella Berchiolli and Gioachino Coppi and Marco Gesi and Vincenzo Ferrari and Mauro Ferrari},
  journal={Computer Assisted Surgery},
  year={2017},
  volume={22},
  pages={27 - 38}
}
Abstract Purpose: The in situ fenestration of a standard endograft is currently limited by difficulties in targeting the fenestration site under fluoroscopic control and by the lack of a safe method to perforate the graft. Evidence in the literature suggests the use of a 3 D electromagnetic navigator to accurately guide the endovascular instruments to the target and a laser to selectively perforate the graft. The aim of this work is to provide design guidelines to develop a sensorized catheter… 
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TLDR
Preliminary in vitro trials demonstrate the feasibility of the proposed instrumentation which could widespread the procedure for in situ fenestration and has the potential to expand indications for standard endovascular aneurysm repair to cases of acute syndromes.
An Experimental Study of Laser in situ Fenestration of Current Aortic Endografts.
Ex vivo efficacy demonstration of a laser fenestration system for endovascular abdominal aortic aneurysm repair (EVAR)
TLDR
An ex-vivo study providing the harmlessness of laser irradiation effects on biological tissue surrounding the endograft wall is reported, suggesting that the diode laser can be safely used for the proposed surgical application.
In situ diode laser fenestration: An ex‐vivo evaluation of irradiation effects on human aortic tissue
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A three‐dimensional navigation system for the accurate targeting of the fenestration site is described and results of an ex vivo study suggest that the diode laser can be safely used for the proposed surgical application.
Software Framework for VR-Enabled Transcatheter Valve Implantation in Unity
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This work proposes an EM navigation platform, with software functionalities, developed using the Unity game engine, to mimic physical behaviors of surgical instruments inside the patient vasculature, handle the interaction between the tools and the anatomical model via collision detection, and deform in real-time the anatomy.
Antegrade in situ laser fenestration of aortic stent graft during endovascular aortic repair: A case report
TLDR
This study suggests the feasibility and short-term safety of this novel antegrade in situ laser fenestration technique for select JAAA patients.

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