A Variable Bending Stiffness Instrument: The AlKingScope: A Proof of Concept Prototype

When treating a Chronic Total Occlusion (CTO) via Percutaneous Coronary Intervention (PCI), a guidewire first needs to be passed through or around the occlusion, a task requiring considerable skill and clinician experience. Proper backup support for the guidewire being used by the clinician is a prerequisite to prevent buckling or uncontrolled...

Crossing Total Occlusions Using a Hydraulic Pressure Wave: Development of the Wave Catheter

With the ongoing miniaturization of surgical instruments, the ability to apply large forces on tissues for resection becomes challenging and the risk of buckling becomes more real. In an effort to allow for high force application in slender instruments, in this study, we have investigated using a hydraulic pressure wave (COMSOL model) and...

Invasive Coronary Artery Imaging Using Optical Coherence Tomography: A Cost-effectiveness and Implementation Process Analysis

The aim of this project was the implementation of optical coherence tomography (OCT), an invasive intracoronary imaging (ICI) tool used for the visualization of coronary arteries. The implementation was performed in a structured manner by: (1) A literature review into the current applications of OCT in relation to current standards; (2) A thesis...

Crossing Total Occlusions using a hydraulic pressure wave: A feasibility study

Crossing highly calcified occlusions is technically challenging mainly due to guidewire buckling. In an effort to prevent buckling, a catheter that uses a dynamic impulse load is proposed. The proposed Wave catheter consists of an input plunger to generate an impulse at the handle, a hydraulic pressure wave confined within a ∅2 mm catheter to...

Hydraulic catheter device for treating chronic total occlusion: A feasibility study

Chronic total occlusion (CTO) occurs in approximately a third of all patients with coronary artery disease and is one of the most challenging types of conditions to treat. Minimally invasive methods like percutaneous coronary intervention (PCI) show a high treating potential as well as low costs, short hospital stay and fast recovery. However,...

Endovascular crossing of Chronic Total Occlusions using an impulse: An explorative design study

In this study we investigated whether exerting an impulse on a Chronic Total Occlusion (CTO) improves the success rate of CTO crossing as compared to the currently used method of statically pushing the guidewire against the CTO. A prototype (Ø2 mm) was developed that generates translational momentum using a spring-loaded indenter and converts it...

Crossing Total Occlusions: Navigating Towards Recanalization

Chronic total occlusions (CTOs) represent the “last frontier” of percutaneous interventions. The main technical challenges lies in crossing the guidewire into the distal true lumen, which is primarily due to three problems: device buckling during initial puncture, inadequate visualization, and the inability to actively navigate through the CTO....