血管内治療デバイスに与えられる操作に対する応答性の評価指標の提案

抄録

In endovascular treatment, guidewire and catheter manipulated manually can often damage blood vessel. One of the reasons for this is that the behavior of the device does not match the operator's expectations. We hypothesized that the ratio of the actual operation given to the device to the actual movement of the device (responsiveness) reflects the position where the device is difficult to be delivered. In order to evaluate the responsiveness, we performed numerical calculation by inserting a guidewire into the blood vessel. The vessel model consists of a combination of bent parts and straight parts. The starting point for data collection was Position A, 55 mm away from the vessel model’s entrance. The end point was set to a cerebral aneurysm (Position F) located 110 mm away from the entrance. We gave a guidewire push operations and rotation operations to deliver the guidewire from Position A to Position F. When the guidewire was located distal to the vessel model’s entrance, the responsiveness of the pushing operation at the flexion of the vessel model was found to be unaffected by the position of the guidewire (inside or outside). From the spatial distribation on the responsiveness of the rotation operation, it was found that the rotation operation should be performed in a straight part. The investigate of the distribution of responsiveness can be expected to specify the region that are difficult for physicians to operate devices in advance.