Evaluation of guidewire path reproducibility
Evaluation of guidewire path reproducibility
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DOI：
10.1118/1.2903430
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发表时间：
2008-05-01
期刊：
影响因子：
3.8
通讯作者：
Dmochowski, Jacek
中科院分区：
文献类型：
--
作者：
Schafer, Sebastian;Hoffmann, Kenneth R.;Dmochowski, Jacek
微创血管介入治疗的数量正在增加。在这些干预中，各种器械被引导并放置在干预部位。几乎所有这些介入手术中使用的器械都是导丝，用作输送到介入部位的所有器械的单轨。然而，即使导丝就位，临床医生在介入期间仍然遇到困难。作为理解这些困难并促进导丝和器械引导的第一步，我们研究了不同因素（用户、材料和几何结构）下血管体模模型中导丝最终路径的再现性。用硅胶管构建了三个血管模型（血管直径类似于4 mm），其迂曲度类似于颈内动脉，并包裹在Sylgard弹性体中。几名经过培训的用户在脉动流条件下反复将两种不同柔性的导丝穿过体模。放置导丝后，采集旋转C形臂图像序列（9 in. II模式，0.185 mm像素尺寸），并重建体模和导丝（512（3），0.288 mm体素尺寸）。重建体积对齐。然后使用区域生长技术确定导丝和体模血管的中心线。不同用户之间的导丝路径相似，但不同材料之间的导丝路径不同。重复放置的平均均方根差为0.17 +/- 0.02 mm（塑料涂层导丝）、0.73 +/- 0.55 mm（钢导丝）和1.15 +/- 0.65 mm（钢与塑料涂层导丝）。对于给定的导丝，这些结果表明导丝路径在形状和位置上相对可再现。(c)2008年美国医学物理学家协会。
The number of minimally invasive vascular interventions is increasing. In these interventions, a variety of devices are directed to and placed at the site of intervention. The device used in almost all of these interventions is the guidewire, acting as a monorail for all devices which are delivered to the intervention site. However, even with the guidewire in place, clinicians still experience difficulties during the interventions. As a first step toward understanding these difficulties and facilitating guidewire and device guidance, we have investigated the reproducibility of the final paths of the guidewire in vessel phantom models on different factors: user, materials and geometry. Three vessel phantoms (vessel diameters similar to 4 mm) were constructed having tortuousity similar to the internal carotid artery from silicon tubing and encased in Sylgard elastomer. Several trained users repeatedly passed two guidewires of different flexibility through the phantoms under pulsatile flow conditions. After the guidewire had been placed, rotational c-arm image sequences were acquired (9 in. II mode, 0.185 mm pixel size), and the phantom and guidewire were reconstructed (512(3), 0.288 mm voxel size). The reconstructed volumes were aligned. The centerlines of the guidewire and the phantom vessel were then determined using region-growing techniques. Guidewire paths appear similar across users but not across materials. The average root mean square difference of the repeated placement was 0.17 +/- 0.02 mm (plastic-coated guidewire), 0.73 +/- 0.55 mm (steel guidewire) and 1.15 +/- 0.65 mm (steel versus plastic-coated). For a given guidewire, these results indicate that the guidewire path is relatively reproducible in shape and position. (c) 2008 American Association of Physicists in Medicine.