A Retrospective Review in Operative Interventions and Outcomes of the Magellan Robotic Endovascular Catheter
The Magellan Robot catheter (Hansen Medical, Mountain View, Calif) recently received clearance by the Food and Drug Administration for use on peripheral vessels. Our institution acquired the system in January 2014. We report our institution's initial experience with the Magellan system.
We retrospectively reviewed the records for all patients who underwent Magellan-assisted endovascular procedures between January 28, 2014, and April 26, 2014. Prior to the first procedure, the attending surgeon and staff underwent simulator and model training and certification for the Magellan system. Patient demographics, comorbidities, and operative statistics were recorded for analysis in accordance with IRB guidelines.
A total of 14 patients (64% male) underwent 15 Magellan-assisted therapies. The average age of our patients was 68 years. Four patients had undergone previous open or endovascular procedures on the treated extremity. Eight procedures involved atherosclerotic occlusive disease of the legs, 3 aortic aneurysm repairs, 2 visceral stenoses, 1 subclavian artery occlusion, and 1 right innominate vein occlusion. One case was aborted due to small iliac and femoral artery access. Two cases were unsuccessful due to failure to cross a venous chronic total occlusion and inability to advance the robotic sheath into the innominate artery. Operative statistics included an average blood loss of 125 ± 114 mL, 57 ± 42 mL contrast use, and 30 ± 14 minutes of fluoroscopy time, with an average radiation exposure of 4866 ± 6639 mGy.
The overall success rate for the Magellan system was 87%. There was a definite learning curve, as evidenced by our longer fluoroscopy times. However, the flexibility of the leader catheter and ability to turn 180º made it possible to treat visceral arteries from the groin. We also found an advantage with the robotic catheter in crossing the iliac bifurcation even in patients with acute angulation or prior stenting. As more centers acquire the Magellan system, we feel participation in the ROVER robotic catheter registry will play a vital role in better defining the proper use of this new technology.
& Matsuura, J. H.
(2014). A Retrospective Review in Operative Interventions and Outcomes of the Magellan Robotic Endovascular Catheter. Journal of Vascular Surgery, 60 (4), 1100.