Fundings US Army
Objective Develop a device to track a catheter, with translation, torque, force feedback
Date 02.2017– 02.2019
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REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) is a potentially life saving procedure to stem bleeding into the abdomen and lower body. A balloon catheter is inserted through into the common femoral artery in the groin specific zones in the aorta and inflated, temporarily blocking blood flow while repairs are effected. It is typically performed without live imaging assistance, and animal-based training is not suitable. A simulation-based training system is needed to allow military and civilian trauma and emergency physicians to learn standard technique and use of new REBOA catheters.
Expanding our previous works on interventional radiology simulation, we are developing a novel simulator for REBOA that will include physical vascular access, simulated passage of the IR instruments into the aorta with accompanying training/educational content, device withdrawal and closure. The tracking system uses optical navigation (laser mouse) sensing to detect catheter/guidewire axial and rotational motion, instrument diameter detection and actuators to generate haptic feedback on the catheter or guidewire. The trackers are designed to be compatible with fluid exposure (supporting inclusion of fake blood) and sterilizability (for potential use in endovascular navigation assistance applications). Trackers mounted to instruments and within the simulator capture needle, femoral catheter, dilator/sheath, guidewire and balloon catheter motions directly or by calculation of motions of instruments relative to each other as they enter a simplified fluidic system.
The system is designed to be compatible with CODA balloon catheters, the newer ER-REBOA catheter and other similar systems. Motion of and reaction forces on the devices passing through the vasculature, and blood flow within virtual vessels is computed in real-time, and synthetic views of virtual instrument motion can be displayed to the trainee to provide understanding of the procedure and illustrate when errors are committed.
Errors such as venous access and incorrect location of balloon inflation can be detected. The underlying software architecture links the wireless, battery powered trackers to a portable tablet or similar interface, which can record performance for later review and evaluation.