A team of engineers and physicians has developed a steerable catheter that for the first time will give neurosurgeons the ability to steer the device in any direction they want while navigating the brain’s arteries and blood vessels. The device was inspired by nature, specifically insect legs and flagella--tail-like structures that allow microscopic organisms such as bacteria to swim.
The team from the University of California San Diego describes the breakthrough in the Aug. 18 issue of Science Robotics.
The steerable catheter was successfully tested in pigs at the Center for the Future of Surgery at UC San Diego.
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Approximately one in 50 people in the United States has an unruptured intracranial aneurysm--a thin-walled, blister-like lesion on a cerebral artery that is prone to rupture. These kinds of lesions affect over 160 million people worldwide, half of them under the age of 50. Of patients that suffer ruptured aneurysms, more than half die. Half of the survivors experience long-term disabilities. Studies show that a quarter of cases cannot be operated on because of how difficult the aneurysms are to reach.
“As a neurosurgeon, one of the challenges that we have is directing catheters to the delicate, deep recesses of the brain,” said Dr. Alexander Khalessi, chair of the Department of Neurological Surgery at UC San Diego Health. “Today’s results demonstrate proof of concept for a soft, easily steerable catheter that would significantly improve our ability to treat brain aneurysms and many other neurological conditions, and I look forward to advancing this innovation toward patient care.”
The current state of the art in aneurysm surgery involves neurosurgeons inserting guidewires into an artery near the groin to take catheters through the aorta and all the way up into the brain. Surgeons use curved-tip guidewires to navigate the brain's arteries and junctions. But these guidewires have to be removed before the catheter’s tip can be used to provide treatment.
“Once the guidewire is retrieved the catheter will return to its native shape, often straight, resulting in loss of access to the pathology,” said Dr. Jessica Wen, who was instrumental in serving as a bridge between clinicians and engineers, and coordinated work with the Center for the Future of Surgery at UC San Diego.
As a result, it is extremely difficult to place and keep it in the right position to release platinum coils that block blood flow to the aneurysm and prevent a brain bleed.