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Tuesday, November 4, 2014

Robot-assisted fibroid embolization

Researchers from London, UK have recently published their early experience with the Magellan robotic catheter for use during uterine artery embolization. The 9-French outer diameter system has a multidirectional bending 6-F leading catheter that is used to catheterize vessels while the operator is seated in the control room, away from ionizing radiation. Where I trained we had something like this, but we were called “fellows” and not “robots.”

The system was used in 5 women with heavy bleeding during menstruation, four of which had fibroids and one that had adenomyosis. All procedures were technically successful and without major or access site complications. Median procedure time in this study was no different than previously published times, but median fluoroscopy time compared favorably to that in the literature for the conventional technique. Based on this early experience, the authors conclude that the use of the Magellan system in uterine artery embolization is feasible and safe.

However, don’t rush to throw your apron into the trash. Although the system can accept a microcatheter in place of a 0.035” wire, the wire manipulator is not currently compatible with microcatheters. So, if you get this system in your angiosuite sometime soon, you’ll still have get up and steer the microcatheter the old-fashioned way . . . or get your fellow to do it.

Click here to see the full abstract

The Magellan workstation

(a, b) The SmartMask function was employed to facilitate cannulation of the right internal iliac artery. Fine movements of the leader tip were then used to direct the microcatheter into the uterine artery.

Citation: Rolls, A. E. et al. Robot-Assisted Uterine Artery Embolization: A First-in-Woman Safety Evaluation of the Magellan System. Journal of Vascular and Interventional Radiology (2014). doi:doi: 10.1016/j.jvir.2014.05.022

Post author: Amish Patel, MD

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