Journal of neurointerventional surgery · 2026
Quantifying expert resistance perception from vessel wall deformation in intracranial catheter navigation.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Uno Takeshi, Shojima Masaaki, Ohta Makoto, Kosukegawa Hiroyuki, Oyama Yuta, Hasegawa Riko, Omiya Ayami, Haga Yoichi, Shin Masahiro
Аннотация
BACKGROUND: Intracranial catheter navigation relies on haptic cues interpreted as resistance. However, resistance perception is subjective, limiting standardized training. Prior studies measured forces at the proximal device end, but vessel-wall deformation during catheter advancement has not been synchronized with expert resistance judgment. In this feasibility study, outer-wall strain was used as a relative index of wall deformation in a tortuous vascular phantom.
METHODS: Six board-certified neurointerventionalists, each performing one navigation trial, advanced a 0.021 inch microcatheter over a 0.014 inch microguidewire through a tortuous vascular phantom with nine sequential bends, eight instrumented with outer-wall strain gauges. Operators reported mild resistance and unacceptable resistance, defined as resistance beyond which advancement was judged unsafe in this phantom. Vessel strain was recorded continuously without real-time feedback.
RESULTS: In this phantom, when mild resistance was first reported, maximum strain among instrumented gauges reached 410.8±102.9 µε, localized approximately two bends proximal to the catheter tip, on average. At unacceptable resistance, maximum strain increased to 850.3±219.8 µε at the most proximal gauge. Peak strain location shifted proximally as perceived resistance escalated, and further distal tip advancement ceased. Strain at unacceptable resistance consistently exceeded that at mild resistance.
CONCLUSIONS: In this phantom, expert resistance perception was associated with reproducible vessel-wall strain patterns. Because microstrain values are model-specific, they should be viewed as relative deformation indices, not patient-applicable thresholds or measures of in vivo wall stress. Linking subjective resistance to quantifiable wall deformation may support objective assessment of resistance perception and proficiency-based simulation training, pending validation.
METHODS: Six board-certified neurointerventionalists, each performing one navigation trial, advanced a 0.021 inch microcatheter over a 0.014 inch microguidewire through a tortuous vascular phantom with nine sequential bends, eight instrumented with outer-wall strain gauges. Operators reported mild resistance and unacceptable resistance, defined as resistance beyond which advancement was judged unsafe in this phantom. Vessel strain was recorded continuously without real-time feedback.
RESULTS: In this phantom, when mild resistance was first reported, maximum strain among instrumented gauges reached 410.8±102.9 µε, localized approximately two bends proximal to the catheter tip, on average. At unacceptable resistance, maximum strain increased to 850.3±219.8 µε at the most proximal gauge. Peak strain location shifted proximally as perceived resistance escalated, and further distal tip advancement ceased. Strain at unacceptable resistance consistently exceeded that at mild resistance.
CONCLUSIONS: In this phantom, expert resistance perception was associated with reproducible vessel-wall strain patterns. Because microstrain values are model-specific, they should be viewed as relative deformation indices, not patient-applicable thresholds or measures of in vivo wall stress. Linking subjective resistance to quantifiable wall deformation may support objective assessment of resistance perception and proficiency-based simulation training, pending validation.