First-in-human, robotic-assisted neuroendovascular intervention

Abstract

Robotic-assisted technology has been used as a tool to enhance open and minimally invasive surgeries as well as percutaneous coronary and peripheral vascular interventions. It offers many potential benefits, including increased procedural and technical accuracy as well as reduced radiation dose during fluoroscopic procedures. It also offers the potential for truly “remote” procedures. Despite these benefits, robotic technology has not yet been used in the neuroendovascular field, aside from diagnostic cerebral angiography. Here, we report the first robotic-assisted, therapeutic, neuroendovascular intervention performed in a human. This was a stent-assisted coiling procedure to treat a large basilar aneurysm. All intracranial steps, including stent placement and coil deployment, were performed with assistance from the CorPath<sup>©</sup> GRX Robotic System (Corindus, a Siemens Healthineers Company, Waltham, MA, USA). This represents a major milestone in the treatment of neurovascular disease and opens the doors for the development of remote robotic neuroendovascular procedures.

Neurointervention in the 2020s: Where are We Going?

“…Closely related to this topic is the introduction of robotics into the neurointerventional routine. To date, few groups have reported small case series of successful robot-assisted elective procedures [ 31 – 33 ], and first attempts are being made to create ethical and medicolegal frameworks [ 34 ] for neurointerventional robotics. The degree of autonomy of current robotic systems is however very low and their utility restricted by the incapability of performing essential tasks, such as puncturing the groin.…”

Remote-Proctoring bei neuroradiologischen Interventionen

“…Die Einsetzbarkeit der Robotertechnologie wird auch in der endovaskulären Therapie neurovaskulärer Erkrankungen ambitioniert vorangetrieben und kontrovers diskutiert [ 28 , 29 ]. Unter viel Aufmerksamkeit wurden Anfang des Jahres 2020 drei Studien publiziert, in denen die roboterassistierte enovaskuläre Coil-Embolisation eines intrakraniellen Aneurysmas, diagnostische Angiographien und das Stenting von Karotisstenosen demonstriert wurden [ 30 – 32 ]. Ähnlich dem Da-Vinci-System bei urologischen Operationen führt ein Roboter hierbei mechanisch genau die Aktionen durch, die ein Operateur an einer Bedieneinheit eingibt.…”

Interhospital teleproctoring of endovascular intracranial aneurysm treatment using a dedicated live-streaming technology: first experiences during the COVID-19 pandemic

“…Another approach for fostering remote neurointerventional procedures is the use of robotics. 5 However, such options are under development and require more time before clinical implementation can be realised. The current need for remote proctoring and/or training demands immediate solutions.…”