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: 10705112
• 负责人: Tania Kiyoye Morimoto
• 金额: $ 42.46万
• 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/10705112
• 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; 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; 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.

项目总结 血管内手术(ES)日益增强或取代传统的脑部、肝脏、 心脏和血管疾病，因为它们改善了临床结果，恢复更快，并改善了更多 死亡率。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。 以及通过工具底座的轴向加载和旋转的组合导航到远端动脉， 利用弯曲的尖端将fl等检测到预期的位置和血管。尽管血管内治疗有很多好处，fi 手术，血管解剖，特别是对老年患者，他们占接受手术的很大一部分 这样的手术，会表现出过度的曲折和严重的角度，导致高风险、时间密集 只有经过专业训练的选定数量的专家才能执行的程序。一小部分人 专科医生的缺乏导致获得必要治疗的机会有限，患者被迫等待和旅行 接受治疗或根本不接受治疗。因此，迫切需要新的血管内机器人 安全、有效的外科手术工具，使更多的外科医生能够成功地导航具有挑战性的解剖结构。 为了满足这一需求，一种名为血管-血管内导航的新软机器人方法通过 扩展名-将使用。当用fluid加压时，这些葡萄藤通过其尖端的延伸导航- NER类似于植物的生长方式，创造出具有复杂曲率的形状。这些藤本植物本身就更安全 由于其柔软的结构，并代表了一种从根本上不同的移动方法。总的目标是 这项工作是表征的行为和重新fi为ES的藤条设计，包括形状控制 方法，并验证其有效性和安全性。中心假设是这种新的板形控制方法 通过尖端延伸的导航使藤本植物能够安全地和↵地穿过维管系统。中环 假说将通过追求三个特定的fic目标来检验：(1)表征和重现fine小规模的、预成型的和 用于ES的可转向藤条设计；(2)在台式模型中评估藤条的安全性；以及(3)验证 整个葡萄藤系统在活体猪研究中。这项工作将是实现长期目标的第一步 目标是创建一种可由大量外科医生操作的软机器人导尿系统，以增加访问权限 到高质量的外科治疗。 这项工作的创新之处在于，所提出的葡萄藤是fi第一外翻，机器人导管具有形状控制和 代表着与目前依赖于推动半刚性工具的现状的实质性背离 从它们的近端。这项工作的预期贡献是一个初步的软的、尖端延伸的机器人系统 能够安全和有效地绕过急转弯和通过血管系统的曲折路径，这是↵ fi是不可能的，因为它最终将导致更多的人获得高质量的微创手术。