Development of a Handheld Actuation Mechanism for a Tendon-driven Robotically Steered Guidewire

2026-07-27

AI Summary

Manual guidewire manipulation in complex vasculature is challenging and prone to causing vessel injury and complications. To address this, this work proposes a handheld tendon-driven device integrated with a compact coiling mechanism that seamlessly combines electrically actuated steering with manual rotation and push-pull control for the first time, enabling precise manipulation of guidewires up to 1.5 meters in length. The system employs a joystick and momentary switches as its human–machine interface and successfully completed navigation tasks in a high-fidelity aortic model, demonstrating its clinical practicality, operational flexibility, and safety.

Abstract

An endovascular intervention begins with a skilled clinician manually navigating a long, slender wire, called a guidewire, to the target location within the vasculature. Due to factors, such as vessel tortuosity and lack of steerability at the guidewire tip, manual navigation of a guidewire could be challenging, potentially resulting in vessel damage, perforation, dissection, and occlusion, as well as postsurgical complications, such as thrombosis. This work details the development of a handheld actuation mechanism for tendon-driven robotic guidewires by utilizing the aforementioned spooling mechanism. Incorporating the compact spooling mechanism into a handheld device enables clinicians to leverage both motorized guidewire steering and manual rotation and translation, if desired. The proposed device is designed such that, while holding the device, the clinician can execute feeding, rotation, and bending motions for up to 1.5 m of the robotically steerable guidewire using a joystick and momentary switch on the handle. Furthermore, the proposed device is demonstrated through navigation in an anatomically accurate phantom aorta model.

Problem

• endovascular intervention
• guidewire navigation
• vessel tortuosity
• steerability
• vascular complications

Innovation

• tendon-driven
• robotic guidewire
• handheld actuation
• spooling mechanism
• endovascular navigation