Assessment of distal access catheter performance during neuroendovascular procedures: measuring force in three-dimensional patient specific phantoms

Background The amount of force applied on a device is an important measure to evaluate the endovascular and surgical device manipulations. The measure has not been evaluated for neuroenodvascular procedures. Purpose We aimed to study the use of force measure as a novel approach to test distal access catheter (DAC) performance during catheterization of cervical and intracranial vessels using patient specific 3-dimentional (3D) phantoms. Methods Using patient specific 3D phantoms of the cervical and intracranial circulation, we recorded measure of force required to deliver three types of DAC s beyond the ophthalmic segment of the internal carotid artery. Six different combinations of DAC -microcatheterguidewire were tested. We intentionally included what we considered suboptimal combinations of DAC s, microcatheters, and guidewires during our experiments to test the feasibility of measuring force under different conditions. A six axis force sensor was secured to the DAC with an adjustable torque used to track axially directed push and pull forces required to navigate the DAC to the target site. Results I n a total of 55 experiments, we found a significant difference in the amount of force used between different DAC s (mean force for DAC A, 1.887 +/- 0.531N; for DAC B, 2.153 +/- 1.280 N; and for DAC C, 1.194 +/- 0.521 N, P=0.007). There was also a significant difference in force measures among the six different catheter systems (P=0.035). Conclusions S ignificant difference in the amount of force used between different DAC s and catheter systems were recorded. Use of force measure in neuroendovascular procedures on 3D printed phantoms is feasible.