  Abdominal Aortic Aneurysms (AAA) are often repaired through an Endovascular
approach known as EVAR. The success and duration of these challenging
procedures are primarily attributable to the accuracy and reliability of
navigating corresponding interventional devices. This study investigates the
performance of conventional non-steerable and steerable catheters in
endovascular aneurysm repair (EVAR) procedures, focusing on two primary
metrics: reachable workspace and gate cannulation success. We developed two
abdominal aortic aneurysm (AAA) phantoms using patient CT images for our
experiments. Under X-ray fluoroscopy guidance, the reachable workspace was
quantified, and gate cannulation success rates, cannulation time, and
fluoroscopy times were recorded for both non-steerable and steerable catheters
and were compared. We were unable to observe statistically significant
differences between the two catheter types in overall cannulation success rates
or fluoroscopy time. However, in challenging anatomical scenarios (particularly
a more challenging gate location), the steerable catheter showed statistically
significant advantages in success rates and cannulation times. While there were
no statistical differences in reachable workspace between non-steerable and
steerable catheters when considering the whole aneurysm, segmented analysis
showed that the steerable catheter performed better in the central region, and
non-steerable catheters performed better in the peripheral region. This study
provides a systematic method for quantifying the performance of endovascular
devices. The findings suggest that while steerable catheters may offer
advantages in complex anatomical conditions, non-steerable catheters are
preferable in peripheral areas of the aneurysm. These insights can inform
catheter selection in EVAR, potentially influencing device design and clinical
practice.
