摘要目的 探索血管介入远程数控机器人系统在血管造影手术中的可行性.方法 在X线透视下遥控血管介入远程数控机器人系统,使配套导管进入血管模型的指定血管.在动物实验中,远程操控该系统,使造影导管分别进入巴马小型猪的主动脉弓部各主要分支并完成全脑血管造影,记录上述过程的技术成功率、平均用时及曝光剂量,并与传统造影方法进行比较.结果 各目标血管均成功进入,远程控制MirageTM导管分别进入血管模型中的左锁骨下动脉、左颈总动脉、头臂干动脉、右颈总动脉、右锁骨下动脉各5次,平均用时分别为(21.3±2.8)s、(28.8±5.2)s、(17.7±2.6)s、(31.5±5.1)s和(24.2±3.7)s,平均曝光剂量分别为(9.3 ±1.2) mGy、(12.4±2.2) mGy、(7.4±1.2) mGy、(14.2±2.5)mGy和(10.4±1.9) mGy.完成巴马小型猪全脑数字减影血管造影(DSA),进入左无名动脉、右无名动脉、右折返动脉、颈内动脉总干、左颈内动脉、右颈内动脉的平均用时分别为(41.5±6.8)s、(29.1±3.7)s、(40.7±5.5)s、(40.1±5.8)s、(59.6±9.0)s和(60.3±10.1)s,平均曝光剂量分别为(40.6±6.5) mGy、(36.0±5.2) mGy、(39.8±6.1)mGy、(43.9±6.7)mGy、(51.0±7.4) mGy和(50.1±7.8)mGy,与传统方法造影比较无显著差异.结论 血管介入远程数控机器人系统可以远程操控导管进入血管模型分支及巴马小型猪的分支并行DSA造影,初步验证了该系统具备远程完成血管造影造影手术的可行性.

abstractsObjective To investigate the feasibility of the remote control endovascular robotic system in interventional angiography.Method The endovascular robotic system HeifetzTM and the matched steerable catheter MirageTM were used to cannulate all the target vessels in the vascular model and cerebral arteries originated from the aorta of Bama mini-pigs under fluoroscopic guidance.The technical success rate,cannulation time and exposure dose were all collected and compared with the result of using conventional techniques.Result All the target vessels were successfully cannulated.The average cannulation time for the steerable catheter into left subclavian artery,left common carotid artery,brachiocephalic artery,right common carotid artery and right subclavian artery in the vascular model was (21.3 ±2.8)s,(28.8 ±5.2)s,(17.7 ±2.6)s,(31.5 ±5.1)s and (24.2 ±3.7) s,respectively,while the average exposure dose was (9.3±1.2)mGy,(12.4 ±2.2)mGy,(7.4 ±1.2)mGy,(14.2 ±2.5)mGy and(10.4 ±1.9)mGy,respectively.The endovascular robotic system completed the cerebral angiography in Bama mini-pigs successfully.The average cannulation time for left innominate artery,right innominate artery,right subclavian artery,common internal carotid trunk,left internal carotid artery and right internal carotid artery was (41.5±6.8)s,(29.1±3.7)s,(40.7±5.5)s,(40.1 ±5.8)s,(59.6±9.0)s and(60.3 ±10.1)s,respectively,while the average exposure dose was (40.6 ± 6.5) mGy,(36.0 ± 5.2) mGy,(39.8 ± 6.1) mGy,(43.9 ± 6.7) mGy,(51.0 ± 7.4) mGy and (50.1 ± 7.8) mGy,respectively.There was no significant difference between robotic and conventional group in success rate,cannulation time and exposure dose.Conclusion The remote digital control endovascular robotic system could cannulate the target vessel in both vascular model and complete the cerebral angiography in Bama mini-pigs,which shows the feasibility of using this robotic system in endovascular intervention procedures under remote control.