血管内治療におけるジャンピング現象の定量的評価

抄録

Irregular motion of device tip during endovascular treatment may cause damage to vessel wall. This motion is called jumping phenomenon. The purpose of this study was to detect signs of this motion and to find a method to suppress the occurrence of jumping. A guidewire was inserted into four different vascular phantoms that simulated actual vascular shapes. The guidewire tip is directed to the right or left in the direction of advance. The device motion was recorded by a camera from one direction. Device shapes were extracted from images divided from the video. The distance of guidewire tip moved, the change in strain energy, and the change in local curvature were also calculated. Eight insertion experiments were performed. A total of 23 jumps (2.58 ± 2.05 mm) were observed during these insertion processes. When device tip was directed in the same direction as vascular curve, the frequency of tip stop decreased. During the occurrence of a jump, it was observed that the accumulated strain energy was released. However, even when strain energy was accumulated, sometimes no jump occurred. The change in curvature of the guidewire was greater when a large jump (6.89 mm) occurred compared to when a small jump (2.39 mm) occurred. This change was greater at bends with greater vessel curvature. This suggests that surgeons should focus on bends with greater vessel curvature to detect signs of guidewire jumps.