Ultrasound-Guided Catheterization Using a Driller-Tipped Guidewire With Combined Magnetic Navigation and Drilling Motion

Abstract

The endovascular intervention has been widely used to treat occlusive peripheral vascular disease (PVD). However, the current procedure has concerns such as low successful rate, undesired trauma, and radiation exposure. This article proposes a robotic solution to mitigate these limitations. A miniature magnetic driller-tipped guidewire (MDG) is designed, which performs 1) controllable bending under directional magnetic fields to navigate in complex vasculature and 2) mechanical drilling under rotating magnetic fields to pass through clogged regions. An integrated actuation system is adopted for magnetic control and ultrasound (US) imaging in a large workspace. A control framework composed of the preoperative and intraoperative stages is developed, which internally coordinates all system modules, addresses noisy US imaging, and provides convenient operation. Demonstrations under an optical camera verify the flexible steering ability and effective unclogging motion of the MDG. Furthermore, US image-monitored <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">in vitro</i> experiments validate the overall hardware platform and control strategy. The designed MDG realizes dual objectives, including controllability at bifurcations and penetrability at clots. The introduced US imaging modality largely reduces radiation hazards in conventional catheterization. This article studies the intervention of the MDG under electromagnetic field navigation and US imaging guidance. The proposed workflow has the potential to improve operational safety and clinical outcomes of the occlusive PVD treatment.