Testing Radial Access Catheters: The Advantages of Modified Human Live Cadaver Models

Introduction: The effectiveness and safe use of endovascular devices rely on closely simulating real-world scenarios during preclinical testing. This study optimized the "human live cadaveric" model for testing radial access catheters. Such preclinical testing platforms are critical for advancing our endovascular knowledge, tools, and techniques for developing and evaluating new radial access catheters.

Methods: A human cadaveric model was created by catheterizing the thoracic aorta in a cadaver model consisting of the head, neck, bilateral arms, and torso. An endoscopic camera was inserted through the ascending aorta to evaluate radial access catheter performances. Blood-mimicking fluid was circulated in the cadaver model using an external pump. Bilateral radial access was obtained using 6F slender sheaths. Experienced neuro-interventionists utilized validated questionnaires employing a 5-point Likert scale to assess the model's arms, aortic arch, and carotid/vertebral arteries in terms of anatomical accuracy, roadmap angiography, device manipulation, haptic feedback, comparison to clinical cases, radio-opacity of devices, and similarity to actual patients.

Results: Both radial arteries were intact, and there were no issues regarding access. The contrast angiographies revealed no obstruction in the micro- or macro-vasculature. Failure mechanisms of access catheters were identified with the model. Firstly, it was observed that embolic plaques detached from the calcified vessel walls during catheter tip manipulation because of prolonged manipulation in selective catheterization. Secondly, Penumbra Select and Cook Simmons 2 catheters were observed under irregular conditions of the aortic arch and assessed performances. Overall similarity scores were 4.75±1.06 in all groups. There was no statistical difference between the catheters.

Conclusion : Prolonged manipulation of radial access catheters can cause releasing fragments from calcified vessels. The model provided a reliable and accurate human radial and aortic vasculature simulation, allowing for the evaluation of catheter performance and potential usefulness in clinical settings.