With FORS technology, clinicians can carry out parts of minimally-invasive interventions without the need for X- ray, which should minimize the risks associated with long-term radiation exposure.
Thanks to 3D Hub technology, you can continue to work with the catheters you’re already used to. The 3D Hub, in combination with FORS-enabled guidewires, enables your catheters to be visualized inside the body.
A professor of vascular surgery talks about the benefits of carrying out minimally- invasive endovascular aortic repair using visualization that doesn’t require X- ray.
Bijan Modarai, Professor of Vascular Surgery at Guy's and St. Thomas' NHS Foundation Trust and King's College, London.
A four-core optical fiber is integrated into a guidewire. By sending light into this fiber and then analyzing how the light is reflected back along the length of the fiber, it becomes possible to calculate the shape as well as the perspective. In fact, you can ‘see’ the whole fiber, and thereby the guidewire (and a catheter slid over it). In real time. There is no need for additional external imaging technology; the device literally visualizes itself.
X-ray is still necessary to visualize the patient anatomy. FORS technology only visualizes devices. However, FORS has already been shown to reduce radiation exposure, for the patient and staff, during complex aortic procedures.
FORS is already accurate enough for top-level vascular surgeons in real-life interventions. For more details on accuracy, see: Three-Dimensional Visualization of Endovascular Guidewires and Catheters Based on Laser Light instead of Fluoroscopy with Fiber Optic RealShape Technology Jansen, van Herwaarden et al. European Journal of Vascular & Endovascular Surgery. DOI: doi.org/10.1016/j.ejvs.2020.02.035 "FORS based device visualization [is] superior to conventional fluoroscopic imaging, while not affecting the mechanical properties (torquability, pushability) of the FORS-enabled guidewire and catheters." Shape accuracy of fiber optic sensing for medical devices characterized in bench experiments Megens, 't Hooft et al. Technical paper in Medical Physics for fluoroscopy. "The technology achieves submillimeter precision and provides full three-dimensional shape, surpassing the reported precision of other navigation and tracking technologies." 3D Visualization of Navigation Catheters for Endovascular Procedures Using a 3D Hub and Fiber Optic RealShape Bydlon, Flexman et al. RealShape Technology: Phantom Study Results DOI: doi.org/10.1016/j.ejvsvf.2023.05.006 "Visualization of navigation catheters is highly accurate with the 3D Hub technology."
Yes. FORS has been specifically designed to work with standard catheters, in combination with the Philips 3D Hub. The Fiber Optic RealShape technology is integrated into the guidewire that the catheter slides over, and not the catheter itself.
Pre-clinical study results by Prof. Joost van Herwaarden at Aortic Live symposium 2018
FIH study results by Prof. Joost van Herwaarden at LINC 2020
Fiber Optic RealShape technology in practice by Prof. Tilo Kölbel at LINC 2020
Expanding clinical experience using Fiber Optic technology in complex aortic repair by Prof. Tilo Kölbel at CX 2020
3D catheter agnostic guidance by Prof. Marc Schermerhorn at CX 2021
FORS Technology: Branched Clinical Usage, Learnings And Future Perspectives by Prof Tilo Kölbel at LINC 2022
Latest Clinical cases using FORS technology and Data published to-date by Tilo Kölbel at LINC 2023
Updated Experience with Fiber Optic RealShape – technology (FORS): Advantages and Limitations by Joost van Herwaarden at VEITH 2023
Edited case shared by Prof. Joost van Herwaarden at CX 2019
Edited case (FEVAR) shared by Prof. Tilo Kölbel at both Aortic Live 2020 and LINC 2021
Edited case (BEVAR) shared by Prof. Tilo Kölbel at CX Aortic 2021
Clinical: Superficial Femoral Artery Recanalization Using Fiber Optic RealShape Technology
Topic / Title | Authors (Institution) | Journal | Date (Published) | Link |
Technical: Shape accuracy of fiber optic sensing for medical devices characterized in bench experiments | Megens (Philips), […], ‘t Hooft (Philips) | Medical Physics | Apr 2021 | |
Technical: 3D Visualisation of Navigation Catheters for Endovascular Procedures Using a 3D Hub and Fiber Optic RealShape Technology: Phantom Study Results | Torre M. Bydlon (Philips), Molly L. Flexman (Philips) | EJVES – Vascular forum | May 2023 Online ahead of print | |
Pre-Clinical: Three Dimensional Visualization of Endovascular Guidewires and Catheters Based on Laser Light instead of Fluoroscopy with Fiber Optic RealShape Technology: Preclinical Results | Jansen (UMCU), […], Van Herwaarden (UMCU) | EJVES | Jul 2020 | |
Clinical: First in Human Clinical Feasibility Study of Endovascular Navigation with Fiber Optic RealShape (FORS) Technology | Van Herwaarden (UMCU), […], Hazenberg (UMCU) | EJVES | Nov 2020 | |
Clinical: Fiber Optic RealShape technology in endovascular surgery | Finnesgard (UMASS), […], Schanzer (UMASS) | Seminars in Vascular Surgery | Oct 2021 | |
Clinical: Fiber Optic RealShape (FORS) Technology for Endovascular Navigation in Severe Tortuous Vessels | Panuccio (UKE), […], Kölbel (UKE) | Journal of Endovascular Therapy | Jan 2022 | |
Clinical: Fiber Optic RealShape Guidance in Endovascular Aortic Repair | Finnesgard (UMASS), [..], Schanzer (UMASS) | Endovascular Today | Mar 2022 | |
Clinical: Superficial Femoral Artery Recanalization Using Fiber Optic RealShape Technology | Klaassen (UMCU), […], Hazenberg (UMCU) | Medicina | Jul 2022 | |
Clinical: Endovascular Navigation with Fiber Optic RealShape (FORS) Technology: prospective analysis of the first 50 patients at UHZ | Panuccio (UKE), […] Kölbel (UKE) | JVS | Aug 2022 | |
Guidelines: Mention of FORS in the ESVS Radiation Safety Guidelines | Modarai et al (GSST) | ESVS | Sept 2022 | |
Clinical: Initial Single Center Experience Using Fiber Optic RealShape Guidance in Complex Endovascular Aortic Repair (follow-up to NESVS abstract) | Finnesgard (UMASS), […], Schanzer (UMASS) | JVS | Nov 2022 | |
Clinical: Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound | Hazenberg (UMCU), […], Van Herwaarden (UMCU) | JOVE | Apr 2023 | |
Clinical: Fiber Optic RealShape (FORS) imaging using upper extremity and transfemoral access for Fenestrated-Branched Endovascular Aortic Aneurysm Repair (FBEVAR) | Pavarino (UTSW), […], Timaran (UTSW) | JVS-CIT | Apr 2023 Online ahead of print | |
Clinical: Radiation Dose Reduction During Contralateral Limb Cannulation Using Fiber Optic RealShape Technology in Endovascular Aneurysm Repair | Klaassen (UMCU),(….), Heerwaarden (UMCU) | EJVS | Nov 2023 | |
Clinical: The effect of Fiber Optic RealShape technology on the reduction of radiation during complex endovascular surgery | Sanders (BIDMC),(….), Schermerhorn (BIDMC) | JVS | Nov 2023 |
Clinical: Initial Single Center Experience Using Fiber Optic RealShape Guidance in Complex Endovascular Aortic Repair (follow-up to NESVS abstract)
B-Learning interview between Prof. Joost van Herwaarden and Prof. Tilo Kölbel, done at VEITH 2019
Meet the Expert session as recorded during CX21. Discussion panel with Limited Editions sites
B-Learning interview between Prof. Tilo Kölbel, Prof. Joost van Herwaarden, and Prof. Geert Willem Schurink, May 2021
Panel discussion with Limited Edition during CX Aortic 2021
Symposium by Prof. GW Schurink at LINC 2022
[1] *The FORS-enabled guidewire as well as compatible endovascular catheters.
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