EP-4736801-A1 - ROBOTIC CATHETER MANIPULATOR

Abstract

The disclosure notably relates to a robotic catheter manipulator that comprises a pneumatic gripper, the pneumatic gripper providing a first state for gripping a catheter and a second state for releasing the catheter, and a positioning system on which the pneumatic gripper is maintained.

Inventors

• RABENOROSCOA, Kanty
• CHARBONNIER, Guillaume
• ROUX, PIERRE
• HAOUAS, Wissem
• ROUGEOT, Patrick
• BIONDI, Alessandra
• MOULIN, THIERRY

Assignees

• Université Marie et Louis Pasteur
• École Nationale Supérieure de Mécanique et des Microtechniques
• Centre National de la Recherche Scientifique
• Centre Hospitalier Régional Universitaire de Besançon

Dates

Publication Date

20260506

Application Date

20241031

Claims (15)

1. A robotic catheter manipulator, comprising: - a pneumatic gripper, the pneumatic gripper providing a first state for gripping a catheter and a second state for releasing the catheter; and - a positioning system on which the pneumatic gripper is maintained.
2. The robotic catheter manipulator of claim 1, wherein the pneumatic gripper comprises a cavity adapted to receive the catheter on a portion thereof, the cavity forming a wall around the portion of the catheter, the wall comprising one or more pneumatic cushions; and wherein the pneumatic gripper provides the first state when the one or more pneumatic cushions are inflated and provides the second state when the one or more pneumatic cushions are deflated.
3. The robotic catheter manipulator of claim 3, wherein the one or more pneumatic cushions are fluidly interconnected.
4. The robotic catheter manipulator of claim 2 or 3, wherein the pneumatic gripper has an elongated shape, preferably the elongated shape is a cylinder; and wherein the cavity adapted to receive the catheter on a portion thereof has an elongated shape with a diameter comprises between 1mm and 3mm, preferably between 1.5mm and 1.85mm.
5. The robotic catheter manipulator of any one of claims 2 to 4, wherein the cavity is substantially a cylindric, the cavity form a through-hole, and the wall comprising one or more pneumatic cushions has a thickness which is substantially the same along its length.
6. The robotic catheter manipulator of anyone of claims 1 to 5, further comprising an inlet and an outlet fluidly connected with the pneumatic gripper, preferably the inlet and outlet being merged.
7. The robotic catheter manipulator of anyone of claims 1 to 6, wherein the positioning system comprises a first actuator for displacing the pneumatic gripper about a first axis and a second actuator for rotating the pneumatic gripper about the first axis.
8. The robotic catheter manipulator of claim 7, wherein the robotic catheter manipulator further comprises a body comprising at least one guide forming the first axis, the pneumatic gripper being movable along the guide.
9. The robotic catheter manipulator of claim 7 or 8, wherein the first and second actuators comprise compressed-air stepper motors or others electric motors.
10. The robotic catheter manipulator of anyone of claims 1 to 9, wherein the robotic catheter manipulator further comprises a clamp for securing one end of the catheter.
11. A method of robotically guiding a catheter, comprising: - providing the robotic catheter manipulator of any one of claims 1 to 10; - introducing a catheter in the pneumatic gripper; - commanding, by an operator, the positioning system to: -- provide the first state for gripping the catheter; -- command positioning system to translate and/or rotate the pneumatic gripper from a first position to a second position; -- command the positioning system to provide the second state for releasing the catheter; and - repeating the commanding of the positioning system until the catheter is positioned as requested by the operator.
12. The method according to claim 11, wherein the catheter is a telescopic catheter comprising two or more tubes with a range of diameters that fit within each other, further comprising: - providing a robotic catheter manipulator for each of the two or more tubes; - commanding successively, by an operator, the positioning system for each tube of the telescopic catheter, starting with the largest diameter tube and ending with the smallest diameter tube.
13. A robotic catheter placement system, comprising: - one or more robotic arms providing up to six degrees of freedom, each of the one or more robotic arms comprising one robotic catheter manipulator according to any one of claims 1 to 10; - a command unit for configuring: - - the position of the one or more robotic arms; - - the selection of the first and second states for each of the said one robotic catheter manipulator; and - - the positioning system.
14. The robotic catheter placement system of claim 13, wherein the control unit comprises a processing unit and a memory storing instructions that, when executed by the processing unit, cause the command unit to configure the position of the one or more robotic arms, configure the selection of the first and second states for each of the said one robotic catheter manipulator, and configure the positioning system.
15. A computer program comprising instructions for causing in real-time the command unit of claim 14 to configure the position of the one or more robotic arms, configure the selection of the first and second states for each of the said one robotic catheter manipulator, and configure the positioning system.

Description

TECHNICAL FIELD The disclosure relates to the field of robotic catheter manipulators for interventional neuroradiology. BACKGROUND Interventional neuroradiology (IN) or neurointervention or endovascular neurosurgery uses medical imaging and minimally invasive technologies to treat vascular conditions involving the central nervous system, especially the brain. Interventional neuroradiology procedures are effective and safe, particularly for treating acute ischemic stroke (AIS) also referred to as strokes or brain attacks. An AIS is an interruption of cerebral blood flow. A stroke occurs when a blockage in an artery prevents blood from reaching cells in the brain. Interventional neuroradiology is also used to treat conditions hemorrhagic strokes caused by aneurysms, arteriovenous malformations (AVMs), and other vascular abnormalities in the brain. Neurointerventions procedures are generally done in an angio suite or cath-lab, similar to an operating room, but with special X-ray equipment (e.g. live fluoroscopy, digital subtracted angiography, 3D rotational imaging capability), which allows the physician to precisely navigate medical devices insides the human vasculature. Minimally invasive technologies comprise the use of interventional tools such as guidewires and catheters. Guidewires are primarily a navigation tool used to create a pathway, while catheters are the instrument that perform the actual medical procedure, such as delivering treatment or performing an intervention. Guidewires allow operators to traverse along a given vessel or along a track of vessels. A guidewire is a thin, flexible wire that is used to enter small and tortuous vessels to act as a guide for subsequent insertion of another instrument such as a microcatheter or balloon catheter. Catheters used for neuro interventions are specifically designed for navigating the complex and delicate blood vessels of the brain. A typical schematic of a full range of neuro-interventional products for a neurointervention comprises one or more guide catheters that are large and robust catheters that allow smaller catheters to pass through and facilitate the placement of various medical devices while providing stability during the procedure, e.g.. It can further comprise one or more intermediate catheters, each being designed to provide stability by reducing the tendency of the microcatheter to move during delivery/implantation of medical devices. It also comprises a microcatheter with a small diameter that can be tracked over a guidewire in order to reach the target lesion; the microcatheter may be replaced by a balloon catheter, which is a soft catheter with an inflatable balloon at its tip. The set of robust, intermediate and micro catheters form a system of telescopic catheters. A neurointervention involves inserting the system of telescopic catheters into a peripheral artery, e.g. the inguinal crease. The guide catheter is navigated to the origin of the internal cervical carotid artery. An intermediate catheter is inserted in the guide catheter and navigates the proximal intracranial vessels. Finally, a microcatheter is inserted which navigates more distally in the intracranial vessels. The navigation catheters may use guidewires that can be telescopically mounted too. The handling of these telescopically mounted catheters/guides is not made possible for robotic assistants that have been developed for interventional cardiology. These robotic assistants allow catheters to be manipulated using cables or magnetic actuation, but they all suffer a major drawback that is they can only manipulate a microcatheter and a micro guide. In other words, they are not able to manipulate telescopically mounted catheters or guides. In addition, these robotic assistants can only handle a limited number of catheters and guides whereas a wide range of catheters and guides in terms of diameter, length, flexibility... exist. For these reasons, none of these robotic assistants can perform a complete interventional neuroradiology procedure as they cannot handle more than two telescopically mounted catheters. Within this context, there is still a need for an improved robotic catheter manipulator in interventional neuroradiology procedure. It is therefore provided a robotic catheter manipulator that comprises a pneumatic gripper, the pneumatic gripper providing a first state for gripping a catheter and a second state for releasing the catheter; and a positioning system on which the pneumatic gripper is maintained. The method may comprise one or more of the following: the pneumatic gripper comprises a cavity adapted to receive the catheter on a portion thereof, the cavity forming a wall around the portion of the catheter, the wall comprising one or more pneumatic cushions; and wherein the pneumatic gripper provides the first state when the one or more pneumatic cushions are inflated and provides the second state when the one or more pneumatic cushions are deflated;the one or