Electromagnetic navigation platform for endovascular surgery: how to develop sensorized catheters and guidewires

Background Endovascular procedures are nowadays limited by difficulties arising from the use of 2D images and are associated with dangerous X-ray exposure and the injection of nephrotoxic contrast medium. Methods An electromagnetic navigator is proposed to guide endovascular procedures with reduced radiation dose and contrast medium injection. Five DOF electromagnetic sensors are calibrated and used to track in real time the positions and orientation of endovascular catheters and guidewires, while intraoperative 3D rotational angiography is used to acquire 3D models of patient anatomy. A preliminary prototype is developed to prove the feasibility of the system using an anthropomorphic phantom. Results The spatial accuracy of the system was evaluated during 70 targeting trials obtaining an overall accuracy of 1.2 0.3 mm; system usability was positively evaluated by three surgeons. Conclusions The strategy proposed to sensorize endovascular instruments paves the way for the development of surgical strategies with reduced radiation dose and contrast medium injection. Further in vitro, animal and clinical experiments are necessary for complete surgical validation