Electromagnetic guided in-situ laser fenestration of endovascular stent-graft: Endovascular tools sensorization strategy and preliminary laser testing

The in-situ endograft fenestration, a possible surgical option for the minimally invasive treatment of aneurysms with unfavorable anatomy, is today limited by difficulties in targeting the fenestration site and by the lack of a safe method to perforate the graft. In this work we suggest the use of: a 3D electromagnetic (EM) navigator, to accurately guide the endovascular instruments to the target, and a laser system, to selectively perforate the graft. More particularly we propose to integrate a laser fiber into a sensorized guidewire and we describe an EM sensorization strategy to accurately guide the laser tool. Finally we preliminary explore different laser irradiation conditions to achieve a successful endograft fenestration and we verify that the heating generated by the laser doesn’t damage the EM coils.