Enhancing Bioelectric Navigation for Catheter Displacement and Direction Assessment

Overview

This study proposes an extension to bioelectric navigation by adding a stationary electrode inside the blood vessel to estimate catheter displacement and movement direction. Evaluations in simulations and 3D printed phantoms demonstrate improved localization accuracy and the ability to detect bidirectional catheter motion, addressing key limitations of current bioelectric navigation.

Background

Minimally invasive endovascular surgery relies on fluoroscopic imaging for catheter navigation, which exposes patients and staff to radiation and requires nephrotoxic contrast agents. Bioelectric navigation is a novel technique that uses local electric fields generated by electrodes on the catheter to identify vascular branches without fluoroscopy. However, it currently lacks precise localization between vascular features and assumes unidirectional catheter movement, limiting its clinical utility. Enhancing bioelectric navigation with additional sensing could reduce radiation exposure and improve procedural safety.

Data Highlights

Simulations and 3D printed phantom experiments were conducted to evaluate the proposed method. The addition of a stationary electrode enabled estimation of catheter displacement along the vascular centerline and detection of movement direction. Modifications were proposed to mitigate signal interference from surrounding tissue. The approach showed promise in improving localization accuracy compared to conventional bioelectric navigation.

Key Findings

• Adding a stationary electrode inside the blood vessel allows generation of an electric field between this electrode and the catheter electrode, enabling displacement and direction sensing.
• The method can estimate catheter position along the vascular branch centerline, overcoming the lack of localization accuracy between vascular features.
• It detects bidirectional catheter motion, addressing the limitation of previous bioelectric navigation which assumed monotonous forward movement.
• Finite element method (FEM) simulations revealed that surrounding tissue can degrade signal quality, but proposed modifications can mitigate these effects.
• The approach can be integrated with existing bioelectric navigation electrodes, avoiding additional hardware complexity on the catheter.
• This enhanced bioelectric navigation could reduce reliance on fluoroscopy, lowering radiation dose and contrast agent use during endovascular procedures.

Clinical Implications

Incorporating a stationary electrode for bioelectric navigation can provide real-time, non-fluoroscopic catheter localization with improved accuracy and directional information. This advancement may reduce radiation exposure and contrast agent administration during endovascular interventions, enhancing patient and staff safety. The technology has potential as an adjunct to fluoroscopy, reserving imaging for critical procedural steps.

Conclusion

The proposed extension of bioelectric navigation with a stationary intravascular electrode enables accurate catheter displacement and direction assessment, addressing key limitations of the original method. This innovation supports safer, less invasive vascular interventions by reducing dependence on fluoroscopic guidance.

References

1. Original bioelectric navigation concept [1]
2. Comprehensive review of non-fluoroscopic tracking systems [2]
3. CARTO 3 cardiac navigation system [3]
4. EnSite NavX system [4]
5. Kodex EPD system [5]