TY - JOUR
T1 - Feasibility of electromagnetically guided transjugular intrahepatic portosystemic shunt procedure
AU - Isfort, Peter
AU - Penzkofer, Tobias
AU - Wilkmann, Christoph
AU - Na, Hong Sik
AU - Kotzlowski, Christian
AU - Ito, Nobutake
AU - Pfeffer, Joachim Georg
AU - Bisplinghoff, Stefan
AU - Osterhues, Sabine
AU - Besting, Andreas
AU - Gooding, Jorge
AU - Schmitz-Rode, Thomas
AU - Kuhl, Christiane
AU - Mahnken, Andreas Horst
AU - Bruners, Philipp
N1 - Publisher Copyright:
© 2016 SMIT - Society for Minimally Invasive Therapy.
PY - 2017/1/2
Y1 - 2017/1/2
N2 - Objectives: To develop an electromagnetic navigation technology for transjugular intrahepatic portosystemic shunt (TIPS) creation and translate it from phantom to an in-vivo large animal setting. Material and methods: A custom-designed device for TIPS creation consisting of a stylet within a 5 French catheter as well as a software prototype were developed that allow real-time tip tracking of both stylet and catheter using an electromagnetic tracking system. Feasibility of navigated TIPSS creation was tested in a phantom by two interventional radiologists (A/B) followed by in-vivo testing evaluation in eight domestic pigs. Procedure duration and number of attempts needed for puncture of the portal vein were recorded. Results: In the phantom setting, intervention time to gain access to the portal vein (PV) was 144 ± 67 s (A) and 122 ± 51 s (B), respectively. In the in-vivo trials, TIPS could be successfully completed in five out of eight animals. Mean time for the complete TIPS was 245 ± 205 minutes with a notable learning curve towards the last animal. Conclusions: TIPS creation with the use of electromagnetic tracking technology proved to be feasible in-vitro as well as in-vivo. The system may be useful to facilitate challenging TIPSS procedures.
AB - Objectives: To develop an electromagnetic navigation technology for transjugular intrahepatic portosystemic shunt (TIPS) creation and translate it from phantom to an in-vivo large animal setting. Material and methods: A custom-designed device for TIPS creation consisting of a stylet within a 5 French catheter as well as a software prototype were developed that allow real-time tip tracking of both stylet and catheter using an electromagnetic tracking system. Feasibility of navigated TIPSS creation was tested in a phantom by two interventional radiologists (A/B) followed by in-vivo testing evaluation in eight domestic pigs. Procedure duration and number of attempts needed for puncture of the portal vein were recorded. Results: In the phantom setting, intervention time to gain access to the portal vein (PV) was 144 ± 67 s (A) and 122 ± 51 s (B), respectively. In the in-vivo trials, TIPS could be successfully completed in five out of eight animals. Mean time for the complete TIPS was 245 ± 205 minutes with a notable learning curve towards the last animal. Conclusions: TIPS creation with the use of electromagnetic tracking technology proved to be feasible in-vitro as well as in-vivo. The system may be useful to facilitate challenging TIPSS procedures.
KW - Image-guided procedures
KW - interventional radiology
KW - vascular intervention
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U2 - 10.1080/13645706.2016.1214155
DO - 10.1080/13645706.2016.1214155
M3 - Article
C2 - 27686414
AN - SCOPUS:84981240708
SN - 1364-5706
VL - 26
SP - 15
EP - 22
JO - Endoscopic surgery and allied technologies
JF - Endoscopic surgery and allied technologies
IS - 1
ER -