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Robot-Assisted Antegrade In-Situ Fenestrated Stent Grafting

  • Celia V. RigaEmail author
  • Colin D. Bicknell
  • Daniel Wallace
  • Mohamad Hamady
  • Nicholas Cheshire
Technical Note

Abstract

To determine the technical feasibility of a novel approach of in-situ fenestration of aortic stent grafts by using a remotely controlled robotic steerable catheter system in the porcine model. A 65-kg pig underwent robot-assisted bilateral antegrade in-situ renal fenestration of an abdominal aortic stent graft with subsequent successful deployment of a bare metal stent into the right renal artery. A 16-mm iliac extension covered stent served as the porcine aortic endograft. Under fluoroscopic guidance, the graft was punctured with a 20-G customized diathermy needle that was introduced and kept in place by the robotic arm. The needle was exchanged for a 4 × 20 mm cutting balloon before successful deployment of the renal stent. Robot-assisted antegrade in-situ fenestration is technically feasible in a large mammalian model. The robotic system enables precise manipulation, stable positioning, and minimum instrumentation of the aorta and its branches while minimizing radiation exposure.

Keywords

Stenting Robotic Fenestration 

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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Celia V. Riga
    • 1
    • 2
    Email author
  • Colin D. Bicknell
    • 1
    • 2
  • Daniel Wallace
    • 3
  • Mohamad Hamady
    • 1
  • Nicholas Cheshire
    • 1
    • 2
  1. 1.Regional Vascular UnitImperial College Healthcare, St Mary’s HospitalLondonUK
  2. 2.Department of Biosurgery and Surgical TechnologyImperial College LondonLondonUK
  3. 3.Hansen MedicalMountain ViewUSA

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