A Review of Robotic Interventional Neuroradiology

Abstract

Robotic interventional neuroradiology is an emerging field with the potential to enhance patient safety, reduce occupational hazards, and expand systems of care. Endovascular robots allow the operator to precisely control guidewires and catheters from a lead-shielded cockpit located several feet (or potentially hundreds of miles) from the patient. This has opened up the possibility of expanding telestroke networks to patients without access to life-saving procedures such as stroke thrombectomy and cerebral aneurysm occlusion by highly-experienced physicians. The prototype machines, first developed in the early 2000s, have evolved into machines capable of a broad range of techniques, while incorporating newly automated maneuvers and safety algorithms. In recent years, preliminary clinical research has been published demonstrating the safety and feasibility of the technology in cerebral angiography and intracranial intervention. The next step is to conduct larger, multisite, prospective studies to assess generalizability and, ultimately, improve patient outcomes in neurovascular disease.

Complete robotic intervention for acute epistaxis in a patient with COVID-19 pneumonia: technical considerations and device selection tips

“…In the future, robotic endovascular systems should be able to function remotely on secured networks and be capable of handling triaxial systems. This will hopefully allow for the possibility of telerobotic acute stroke treatment, thus reducing the geographic access gap to these interventions 8 9. Our experience of coil embolization of the distal internal maxillary artery feeder in a patient with epistaxis and a history of COVID-19 further highlights the potential and benefit of neurointerventional procedures using robotic systems.…”

Evaluation of effect of aneurysm model material on coil contact force and catheter movement

“…These results can be applied to actual surgical procedures. Furthermore, optimizing the insertion conditions will pave the way for improvement of interventional neuroradiology robotic systems, which are being rapidly developed (Beaman et al, 2021;Miyachi et al, 2019;Mendes Pereira et al, 2019). It may also be possible to estimate the contact force based on catheter movement during an actual procedure.…”

“…We also developed a program to track the movement of the catheter tip and evaluated the relationship between the catheter movement and the contact force. The obtained results concerning the effects of the biomodel material and the catheter tip position are expected to be useful in actual surgical procedures, to allow optimal selection of experimental biomodels, and to lead to improved interventional neuroradiology robotic systems (Beaman et al, 2021;Miyachi et al, 2019;Mendes Pereira et al, 2019).…”

Ischemic Penumbra: A Personal View

“…Penumbral imaging may well become an integral component of "telestroke." Linking these technologies is another exciting development, telerobotic thrombectomy [105]. This addresses the critical shortage of expert interventional neuroradiologists outside of comprehensive stroke centers in cities.…”