This paper presents a novel MR-compatible 3-DOF cardiac catheter steering mechanism. The catheter's steerable structure is tendon driven and consists of miniature deflectable, helical segments created by a precise rapid prototyping technique. The created catheter prototype has an outer diameter of 9 Fr (3 mm) and a steerable distal end that can be deflected in a 3-D space via four braided high-tensile Spectra fiber tendons. Any longitudinal twist commonly observed in helical structures is compensated for by employing clockwise (CW) and counter clockwise (CCW) helical segments in an alternating fashion. A 280 μm flexible carbon fiber rod is used as a backbone in a central channel to improve the structure's steering and positioning repeatability. In addition to the backbone, a carbon fiber tube can be inserted into the structure to a varying amount capable of changing the structure's forcibility and, thus, providing a means to change the curvature and to modify the deflectable length of the catheter leading to an extension of reachable points in the catheter-tip workspace. A unique feature of this helical segment structure is that the stiffness can be further adjusted by appropriately tensioning tendons simultaneously. An experimental study has been conducted examining the catheter-tip trajectory in a 3-D space and its positioning repeatability using a 5-DOF magnetic coil tracking system. Furthermore, MRI experiments in a 1.5-T scanner confirmed the MR-compatibility of the catheter prototype. The study shows that the proposed concept for catheter steering has great potential to be employed for robotically steered and MR-guided cardiac catheterization.
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http://dx.doi.org/10.1109/TBME.2013.2276739 | DOI Listing |
PLoS Med
January 2025
Region Västra Götaland, Sahlgrenska University Hospital, Department of Obstetrics and Gynecology, Gothenburg, Sweden.
Background: The risk of perinatal death and severe neonatal morbidity increases gradually after 41 weeks of pregnancy. We evaluated maternal and perinatal outcomes after a national shift from expectancy and induction at 42+0 weeks to a more active management of late-term pregnancies in Sweden offering induction from 41+0 weeks or an individual plan aiming at birth or active labour no later than 42+0 weeks.
Methods And Findings: Women with a singleton pregnancy lasting 41+0 weeks or more with a fetus in cephalic presentation (N = 150,370) were included in a nationwide, register-based cohort study.
J Mech Behav Biomed Mater
January 2025
Department of Biomedical Engineering, Toronto Metropolitan University, Toronto, Canada; Sunnybrook Research Institute, Toronto, Canada.
The integration of self-expandable nitinol frames with cable-driven parallel mechanisms offers a promising advancement in minimally invasive cardiovascular interventions. This study presents the design, fabrication, and verification of a miniaturized self-expandable nitinol frame to enhance catheter tip steerability and navigation within complex vascular anatomies. The frame is reduced in size for delivery through 7-8 Fr sheaths while accommodating diverse vascular diameters, allowing up to a maximum expansion of 15 mm.
View Article and Find Full Text PDFJ Cardiovasc Dev Dis
December 2024
Institute of Cardiovascular Sciences, University of Birmingham, Birmingham B15 2TT, UK.
Introduction: Pulsed-field ablation (PFA) is a novel modality for pulmonary vein isolation in patients with atrial fibrillation (AF). We describe the initial uptake and experience of PFA using a pentaspline catheter across selected National Health Service England (NHSE) centres.
Methods: Data collected by NHSE Specialised Services Development Programme regarding AF ablation procedures using a single-shot, pentaspline, multielectrode PFA catheter (FARAWAVE, Boston Scientific) between June 2022 and August 2024 were aggregated and analysed to examine procedural metrics, acute efficacy and safety outcomes over 3-month follow-up.
Semin Thromb Hemost
December 2024
Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, Florida.
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