CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2019; 03(02): 142-146
DOI: 10.1055/s-0039-1694093
Short Communication
Indian Society of Vascular and Interventional Radiology

Use of the Magellan Robotic System for Conventional Transarterial Chemoembolization (cTACE): A 6-Patient Case Series Showing Safety and Technical Success

1   Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
2   Department of Surgery, Monash University, Clayton, Victoria, Australia
,
Madeleine Scicchitano
1   Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
,
1   Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
,
Tim Joseph
1   Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
,
1   Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
2   Department of Surgery, Monash University, Clayton, Victoria, Australia
› Author Affiliations
Further Information

Publication History

Received: 15 April 2019

Accepted after revision: 27 May 2019

Publication Date:
18 July 2019 (online)

Abstract

Robotic endovascular technology is an emerging concept, and is being developed to allow more precise navigation of anatomy in challenging endovascular cases. The Magellan Endovascular System allows either direct or remote steerability of a 2-point articulating robotic platform with the ability to place a conventional microcatheter through the catheter tip. Such flexibility may help to reach an otherwise difficult anatomic location, especially in variant anatomy. To date, this platform has been shown to be technically successful in a small number of different settings. This case series shows another potential platform for such technology and explores the technical use and overall safety in conventional transarterial chemoembolization (cTACE). The study retrospectively assessed 6 patients undergoing selective cTACE. Treatments were performed in a single center by two experienced interventional radiologists. Fluoroscopy time, radiation dose, anatomic target, and adverse events were logged. In spite of a longer than expected average fluoroscopy time, which can be expected for a first-generation technology, the average radiation dose was comparable to literature and technical success was able to be shown in all 6 patients with no adverse events. This technology has wide scope for future use and once overcoming a learning curve, may allow us to avoid repeat procedure attempts thus reducing fluoroscopy time and leading to earlier successful treatment. Providing a platform of interest and usability in the interventional radiology world may also lead to further development of smaller, cheaper, and more widely-accessible devices.

 
  • References

  • 1 Llovet JM, Brú C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis 1999; 19 (03) 329-338
  • 2 Liapi E, Georgiades CC, Hong K, Geschwind JF. Transcatheter arterial chemoembolization: current technique and future promise. Tech Vasc Interv Radiol 2007; 10 (01) 2-11
  • 3 Antoniou GA, Riga CV, Mayer EK, Cheshire NJ, Bicknell CD. Clinical applications of robotic technology in vascular and endovascular surgery. J Vasc Surg 2011; 53 (02) 493-499
  • 4 Duran C, Lumsden AB, Bismuth J. A randomized, controlled animal trial demonstrating the feasibility and safety of the Magellan™ endovascular robotic system. Ann Vasc Surg 2014; 28 (02) 470-478
  • 5 Del Giudice C, Pellerin O, Nouri NevilleM. et al. Comparison of two endovascular steerable robotic catheters for percutaneous robot-assisted fibroid embolization. Cardiovasc Intervent Radiol 2018; 41 (03) 483-488
  • 6 Livshits I, Lekperic S, Tabori N. et al. Patient radiation exposure in hepatic chemoembolization utilizing cone-beam CT: comparison of transradial and transfemoral approaches. J Vasc Interv Radiol 2017; 28 (05) 775