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Technical Briefs

Enabling Technology for Microvascular Stenting in Ophthalmic Surgery

[+] Author and Article Information
Wei Wei, Claire Popplewell

Department of Mechanical Engineering, Columbia University, New York, NY 10027

Stanley Chang, Howard F. Fine

Department of Ophthalmology, Columbia University, New York, NY 10032

Nabil Simaan1

Department of Mechanical Engineering, Columbia University, New York, NY 10027ns2236@columbia.edu

1

Corresponding author.

J. Med. Devices 4(1), 014503 (Mar 26, 2010) (6 pages) doi:10.1115/1.4001193 History: Received September 01, 2009; Revised February 01, 2010; Published March 26, 2010; Online March 26, 2010

Microstenting is a potentially revolutionary approach to surgical treatment of microvascular retinal disorders that do not resolve using pharmaceutical treatment. This article presents a novel device called a stent deployment unit (SDU) that aims at enabling microstent placement in ophthalmic surgery. The clinical motivation for this work is highlighted in context of microvascular retinal surgery. The proposed SDU is designed for intraocular adjustment of the approach angle and the position of the stent with respect to the retina. The feasibility of this device is experimentally evaluated on chick chorioallantoic membranes and on agar vascular models. Experiments show dependency on the approach angle with respect to the vasculature and on the mobility of the vasculature. Successful placement of stents was achieved in both experimental media. To the best of our knowledge, this pioneering work is the first to demonstrate successful stent deployment in a scale suitable for retinal surgery. We believe that this technique has the promise of enabling effective vascular treatments for blinding conditions such as central and branch retinal vein occlusion.

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Copyright © 2010 by American Society of Mechanical Engineers
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Figures

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Figure 1

(a) Ophthalmic surgical setup; (b) typical tool insertion sites on the eye

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Figure 3

(a) SDU design; (b) retinal microsurgery dual-arm system

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Figure 4

Motion demonstration of the SDU: (a) using angle adjustment tube to change the surgical tool orientation, (b) extending and retracting the guide wire (surgical needle), and (c) using the stent pushing tube to deliver the stent

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Figure 5

Setup overview: (a) experimental setup and (b) Cartesian stage and SDU

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Figure 6

MATLAB control diagram for the robotic stenting system

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Figure 7

Agar stenting experiment: (a) wire piercing the agar surface, (b) stent delivered, and (c) indocyanine green dye injected to demonstrate channel patency

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Figure 8

Chicken membrane experiment 1: (a) initial touch, (b) poking procedure, (c) stent guiding, and (d) stent delivered

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Figure 9

Chicken membrane experiment 2: (a) initial touch, (b) stent delivered, (c) injecting dye, and (d) verification of the stent inside the blood vessel

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Figure 10

Experimental setup for adjusting and optimizing approach angles

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