新型通用型血管腔内介入手术机器人成功实现外周血管支架成形术

A novel universal endovascular interventional robot for peripheral arterial stent-assisted angioplasty

目的:临床上现有的血管腔内介入手术机器人不适用于常用的商品化血管腔内器具,如不同规格的导丝、导管、支架;不能完成血管腔内手术的全步骤,如支架释放等。本研究拟通过初步的动物实验评价新型通用型血管腔内介入手术机器人适应常用商品化血管腔内器具,并实现完成外周血管疾病腔内介入治疗全步骤的可行性。方法:新型通用型血管腔内介入手术机器人系统包括操作控制台及带有夹持式设计的4条机械臂组成。术中选用成年家猪作为实验动物,通过通用型血管腔内介入手术机器人,采用商品化血管腔内器具完成髂动脉支架成形术。结果:新型通用型血管腔内介入手术机器人系统能够使用商品化血管腔内器具,通过远程操控,实现导丝、导管的径向前进、后撤和轴向旋转,通过多个机械臂的配合完成超选及翻山等复杂动作,并成功完成髂动脉自膨式裸支架的释放。手术全程耗时约50min,术者射线下暴露时间小于1min,手术过程平稳,术后造影示移植物定位准确,无支架及手术相关不良反应。结论:新型通用型血管腔内介入手术机器人能够使用商品化血管腔内器具完成外周血管支架成形术。通过设计上的改进解决了支架释放难题,实现腔内介入全步骤远程操作。

Objective:Endovascular interventional robot now faces the difficulty that it could not be fully applied to commercialized endovascular devices,such as guidewires,catheters and stents,which prevents it to complete the entire procedures of endovascular treatment,including stent implantation.This study presents a novel universal endovascular interventional robot and evaluates whether it can be adapted to different commercialized endovascular devices to accomplish the entire endovascular treatment procedures on peripheral vascular disease.Methods:The novel universal endovascular interventional robot consists of two components:the console and the robotic platform with four manipulators.An adult pig was served as the experimental animal.Bilateral iliac artery stents implantation was performed on the pig by the endovascular interventional robot with commercialized endovascular devices.Results:The novel universal endovascular interventional robot can adapt to commercialized endovascular devices.Most interventional procedures,such as pulling,pushing,or rotating can be adapted through remote control.By coordination of multiple manipulators,complex actions such as superselection,crossing action,or implantation of self-expanding bare stent can be realized.The entire procedures took about 50 minutes,and the total exposure time of the surgeon was less than 1 minute.Postoperative angiography showed that the position of the stent grafts was accurate.The procedure was stable without any stent or surgery related complications.Conclusion:The novel universal endovascular interventional robot can realize peripheral arterial stent-assisted angioplasty with commercialized devices.With the improved design,the problem of stent implantation is solved,and remote operation is realized throughout the entire endovascular procedures.