In Vitro Measurement of Tissue Integrity during Saccular Aneurysm Embolizations for Simulator-Based Training

Abstract

In the domain of endovascular neurosurgery, the measurement of tissue integrity is needed for simulator-based training and for the development of new intravascular instruments and treatment techniques. In vitro evaluation of tissue manipulation can be achieved using photoelastic stress analysis and vasculature modeling with photoelastic materials. In this research we constructed two types of vasculature models of saccular aneurysms for differentiation of embolization techniques according to the respect for tissue integrity measurements based on the stress within the blood vessel model wall. In an aneurysm model with 5 mm dome diameter, embolization using MicroPlex 10 (Complex 1D, with 4 mm diameter loops), a maximum area of 3.97 mm² with stress above 1 kPa was measured. This area increased to 5.50 mm² when the dome was touched deliberately with the release mechanism of the coil, and to 4.87 mm² for an embolization using Micrusphere, (Spherical 18 Platinum Coil). In a similar way trans-cell stent-assisted coil embolization was also compared to human blood pressure simulation using a model of a wide-necked saccular aneurysm with 7 mm diameter. The area with stress above 1kPa was below 1 mm² for the pressure simulation and maximized at 3.79 mm² during the trans-cell insertion of the micro-catheter and at 8.92 mm² during the embolization. The presented results show that this measurement system is useful for identifying techniques compromising tissue integrity, comparing and studying coils and embolization techniques for a specific vasculature morphology and comparing their natural stress variations such as that produced by blood pressure.

Keywords

simulator-based training endovascular intervention tissue integrity measurement

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References

Ikeda

Arai

Fukuda

. An in vitro patient specific biological model of the cerebral artery reproduced with a membranous configuration for simulating endovascular Intervention. J Robot Mechatronics. 2005; 17: 327–333.

Ikeda

Tercero

Fukuda

. Patient-specific IVR endovascular simulator with augmented reality for medical training and robot evaluation. J Robot Mechatronics. 2008; 20: 441–448.

Tercero

Ikeda

Tijerino

. Human blood pressure simulation for stress analysis in model of vasculature using photoelastic effect. Int J Automat Technol. 2009; 3: 533–540.

Chaer

DeRubertis

Lin

. Simulation improves resident performance in catheter-based intervention. Ann Surg. 2006; 244: 343–352.

Tercero

Ikeda

Matsushima

. Photoelastic stress analysis error quantification in vasculature models for robot feedback control. IEEE/ASME Trans Mechatronics. 2010; 15: 520–526.

Tercero

Ikeda

Fukuda

. Catheter insertion reference trajectory construction method using photoelastic stress analysis for quantification of respect for tissue during endovascular surgery simulation. Int J Optomechatronics. 2011; 5: 322–339.

Kuske

Robertson

. Photoelastic stress analysis. Wiley-Interscience Publication; 1974. p. 87–109, 263–274.

Matsushima

Tercero

Ikeda

. Photoelastic stress analysis in blood vessel phantoms: three-dimensional visualization and saccular aneurysm with bleb. Int J Med Robot Comput Assist Surg. 2011; 7: 33–41.

Viñuela

. Interventional neuroradiology: endovascular therapy of the central nervous system. New York: Raven Press; 1992. p. 72.

10.

Fukuda

Tercero

Ikeda

. Social impact of in-vitro endovascular surgery simulation technology. In: Proc. IEEE workshop on advanced robotics and its social impacts. Oct. 2010, Seoul.

11.

Hirokawa

Yamamoto

Kawada

. A photoelastic study of ligament strain. IEEE Trans Biomed Eng. 1998; 6: 300–308.

12.

Grecula

Morris

Laughlin

. Femoral surface strain in intact composite femurs: a custom computer analysis of the photoelastic coating technique. IEEE Trans Biomed Eng. 2000; 47: 926–933.