Heiko Maier | Searcharxiv

arXiv2025

Thermally Drawn Bioelectric Catheters: Enabling Proprioceptive Endovascular Navigation

To navigate medical instruments safely and accurately inside a patient's vascular tree, combining X-ray fluoroscopy with intermittent contrast injections is the gold standard. However, prolonged exposure to ionizing radiation poses health risks, necessitates the use of cumbersome lead vests for the clinicians, and contrast injections can lead to acute kidney injury in patients. Bioelectric Navigation, a non-fluoroscopic tracking modality, aims to provide an alternative. It uses weak electric currents to detect local anatomical features in the vasculature and localize instruments without x-ray imaging. In this work, we advance Bioelectric Navigation on two frontiers. Firstly, we introduce a new class of bespokely designed electrode catheters. They are fabricated using 3D printing, thermal drawing, and laser micro-machining. Specifically, we manufacture a 6 Fr catheter incorporating 16 electrodes, a guidewire channel and an additional sensor compartment. We thoroughly assess the catheter's mechanical and electrical properties. Secondly, we introduce an algorithm to localize the catheter along the centerline of a vascular phantom, for the first time fusing electric detection of vascular geometry with electric distance estimation. We report both tracking accuracy and usability evaluated by an expert endovascular surgeon, demonstrating the strong potential of this technology for integration into the existing clinical workflow.

physics.med-ph↗

arXiv2022

Bioelectric Registration of Electromagnetic Tracking and Preoperative Volume Data

For minimally invasive endovascular surgery, the localization of catheters and guidewires inside the human body is essential. Electromagnetic (EM) tracking is one technology that allows localizing such surgical instruments. For localizing intra-operatively EM-tracked instruments with respect to preoperative volume data, it is necessary to bring pre- and intraoperative imaging into the same coordinate frame. In most existing solutions, such registration requires additional interactions, modifying the procedure's original workflow. We propose a new method taking advantage of Bioelectric signals to initialize and register preoperative volumes to the EM tracking system without significantly changing the interventional workflow. We envision the most natural use-case of our concept in cardiac electrophysiology (EP) procedures, in which EP catheters are already equipped with all the necessary sensing, including electric sensing for the measurement of electrophysiological signals and EM tracking for catheter localization. We use EP catheters for Bioelectric sensing to detect local features of the vasculature while advancing the catheter inside the human body. Such features can be automatically labeled before the procedure within the preoperative data. The combination of Bioelectric and EM tracking can localize vascular features such as bifurcations and stenosis within the EM tracking space. Mapping them to preoperative data automatically registers patients' CT space to EM tracking. The proposed registration process is entirely based on Bioelectric sensed features, with no need for external markers or other interventional imaging devices.

physics.med-ph↗