Flexible Instruments for Endovascular Interventions: Improved Magnetic Steering, Actuation, and Image-Guided Surgical Instruments

Endovascular surgery has gained increasing acceptance over the last few years. The current practice of endovascular procedures, however, is limited by some factors including patient-specific operation requirements, high-risk surgery procedures, and time-consuming operations. As a solution, studies have introduced magnetically-actuated surgical catheters to the field of surgical robotics. More recently, advances in steerable catheters and development in the context of magnetic steering have been studied. However, limited research has been conducted in quantifying the effectiveness of magnetic actuation for catheterization procedures. The objectives of this review are to summarize the literature as it relates to catheter-based magnetic steering, actuation, and imaging-guided tracking. The mechanisms for these procedures are then analyzed to provide an extensive overview of the research gaps and their proposed solutions. Endovascular interventions employing magnetically-actuated catheters deliver the promise of higher accuracy and shorter duration when compared to current manual techniques. Moreover, they can allow the surgeons to access these areas of cardiovascular systems, which cannot be reached with standard minimally invasive techniques.