Evaluation of Irregular Motion in Endovascular Treatment

Abstract Vascular intervention using guidewires and catheters has been widely performed, but the selection of appropriate device manipulation is often based on the experience and skills of the surgeon. Occasionally, accidents occur due to unexpected movements of these device tips, resulting in vascular damage. To address the challenge of unpredictable device motions and the associated risk of vessel wall damage, this study aims to investigate how different vessel shapes influence device motions. Additionally, we seek to identify effective manipulation techniques to mitigate these risks. We conducted experiments involving the insertion of a guidewire and a catheter into crank-shaped blood vessel phantom models with three different bending angles. Throughout the experiment, the movement of the inserted guidewire within the blood vessel phantoms was recorded using video recording. It was discovered that jumping distance and number of jumps increased as the distance between the catheter and guidewire tip increased. In experiments with a small bending angle, guidewire jumping was infrequent, but when it occurred, jumps tended to be longer (4.0 ± 2.4 mm). Conversely, experiments involving large bending angles showed short consecutive jumps, with the last jumping distance typically being a relatively longer (2.5 ± 1.3 mm). These findings indicate that irregular motions can be reduced by keeping a catheter close to a guidewire tip. Moreover, when the bending angle is large, a manipulator should be ready to prevent further motions as soon as they notice a small first jump.