Effects of various parameters on guidewire and catheter behavior during catheter introduction

Many guidewire penetration accidents occur during catheter introduction. Therefore, we have evaluated the behavior of medical devices such as guidewires and catheters during catheter introduction using numerical simulations. In our previous study, we evaluated the effects of the insertion velocity of the guidewire and the catheter and confirmed that during catheter introduction, the guidewire imparted a greater load on the vessel wall than that exerted by the guidewire alone. However, it was unclear whether the above phenomenon could also occur under other conditions. In the present study, in addition to these effects, we evaluate the effects of the blood vessel elastic modulus, device insertion length, blood vessel centerline curvature, and their interactions. Furthermore, we evaluate the behavior of the medical devices during guidewire removal after catheter introduction, which was not evaluated in our previous study. We determine the simulation conditions based on the design of experiments and investigate the dominant parameters that affect the contact force between the medical devices and the blood vessel wall using two methods (one that considers parameter interactions and one that does not). We confirm that during guidewire insertion and removal, the device velocity and the vessel centerline curvature have the largest effects, respectively. For the guidewire and the catheter during catheter introduction, the vessel elastic modulus and the insertion velocity have the largest effects, respectively, and the parameter interactions have large effects. These findings are clinically important because they are counterintuitive. During catheter introduction, the average contact forces are larger than those during both guidewire insertion and removal. Furthermore, during guidewire removal, the catheter tip moves in the distal direction.