Mazomenos, EB orcid.org/0000-0003-0357-5996, Chang, P-L, Rippel, RA et al. (6 more authors) (2016) Catheter manipulation analysis for objective performance and technical skills assessment in transcatheter aortic valve implantation. International Journal of Computer Assisted Radiology and Surgery, 11 (6). pp. 1121-1131. ISSN 1861-6410
Abstract
Purpose
Transcatheter aortic valve implantation (TAVI) demands precise and efficient handling of surgical instruments within the confines of the aortic anatomy. Operational performance and dexterous skills are critical for patient safety, and objective methods are assessed with a number of manipulation features, derived from the kinematic analysis of the catheter/guidewire in fluoroscopy video sequences.
Methods
A silicon phantom model of a type I aortic arch was used for this study. Twelve endovascular surgeons, divided into two experience groups, experts (n=6) and novices (n=6), performed cannulation of the aorta, representative of valve placement in TAVI. Each participant completed two TAVI experiments, one with conventional catheters and one with the Magellan robotic platform. Video sequences of the fluoroscopic monitor were recorded for procedural processing. A semi-automated tracking software provided the 2D coordinates of the catheter/guidewire tip. In addition, the aorta phantom was segmented in the videos and the shape of the entire catheter was manually annotated in a subset of the available video frames using crowdsourcing. The TAVI procedure was divided into two stages, and various metrics, representative of the catheter’s overall navigation as well as its relative movement to the vessel wall, were developed.
Results
Experts consistently exhibited lower values of procedure time and dimensionless jerk, and higher average speed and acceleration than novices. Robotic navigation resulted in increased average distance to the vessel wall in both groups, a surrogate measure of safety and reduced risk of embolisation. Discrimination of experience level and types of equipment was achieved with the generated motion features and established clustering algorithms.
Conclusions
Evaluation of surgical skills is possible through the analysis of the catheter/guidewire motion pattern. The use of robotic endovascular platforms seems to enable more precise and controlled catheter navigation.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © The Author(s) 2016. This article is published with open access at Springerlink.com. This is an open access article under the terms of the Creative Commons Attribution License (CC-BY 4.0), which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
Keywords: | Objective skills assessment · Catheter motion analysis · Endovascular robotics |
Dates: |
|
Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Engineering & Physical Sciences (Leeds) > School of Electronic & Electrical Engineering (Leeds) > Robotics, Autonomous Systems & Sensing (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 14 Feb 2020 15:01 |
Last Modified: | 14 Feb 2020 15:01 |
Status: | Published |
Publisher: | Springer Verlag |
Identification Number: | 10.1007/s11548-016-1391-6 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:156468 |
Download
Filename: Mazomenos2016_Article_CatheterManipulationAnalysisFo.pdf
Licence: CC-BY 4.0