Needle guidance system

Our needle guidance system has been evaluated [26,27] in a cadaveric study (Figure 4.5) to evaluate the system for facet joint injection. The... 

Transcoronary venous injection is performed with a catheter system threaded percutaneously into the coronary sinus. Initial studies in swine have confirmed the feasibility and safety of this approach [121]. This delivery method has also been used to deliver skeletal myoblasts to scarred myocardium in cardiomyopathy patients [120]. With intravascular ultrasound guidance, this approach allows the operator to extend a catheter and needle away from the pericardial space and coronary artery into the adjacent myocardium. To date, human feasibility studies have had a good safety profile. This technique is limited, however, by coronary venous tortuosity, lack of site specific targeting, and its own technically challenging nature. Unlike the transendocardial approach, in which cells are... 

Fig. 28.5. Robot for percutaneous needle puncture procedures (PAKY-RCM system). The lower joints are positioned and locked manually, while the upper stages are motorized. The needle positioner at the tip is transparent to X-rays to enable radiographic guidance. [Reproduced from Stoianovici et al. (1998) with permission]...

Fig. 28.8. The CT- and MR-compatible pneumatic robotic instrument guiding system (Innomotion) provides 6-DOF guidance and optional remote biopsy needle insertion...

Minerva [2] was designed for precision image-guided needle placement in stereotactic brain biopsy. The system has 5 DOFs and was designed to intraoperatively control the direction of the tool in real time under computed tomography guidance. 

Sclerotherapy is performed under fluoroscopic control. The puncture with a 24 or 22 Cathlon or 20-gauge Teflon intravenous cannula or other needle system can be done under ultrasound, CT, or MRI guidance. It is necessary to venographically assess the draining veins before injecting sclerosing agents... 

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