Several recent reports of CorPath GRX vascular robot (Cordinus Vascular Robotics, Natick, MA) use intracranially suggest feasibility of neuroendovascular application. Further use and development is likely. During this progression it is important to understand endovascular robot feasibility principles established in cardiac and peripheral vascular literature which enabled extension intracranially. Identification and discussion of robotic proof of concept principals from sister disciplines may help guide safe and accountable neuroendovascular application.
Objective
Summarize endovascular robotic feasibility principals established in cardiac and peripheral vascular literature relevant to neuroendovascular application
Methods
Searches of PubMed, Scopus and Google Scholar were conducted under PRISMA guidelines1 using MeSH search terms. Abstracts were uploaded to Covidence citation review (Covidence, Melbourne, AUS) using RIS format. Pertinent articles underwent full text review and findings are presented in narrative and tabular format.
Results
Search terms generated 1642 articles; 177, 265 and 1200 results for PubMed, Scopus and Google Scholar respectively. With duplicates removed, title review identified 176 abstracts. 55 articles were included, 45 from primary review and 10 identified during literature review. As it pertained to endovascular robotic feasibility proof of concept 12 cardiac, 3 peripheral vascular and 5 neuroendovascular studies were identified.
Conclusions
Cardiac and peripheral vascular literature established endovascular robot feasibility and efficacy with equivalent to superior outcomes after short learning curves while reducing radiation exposure >95% for the primary operator. Limitations of cost, lack of haptic integration and coaxial system control continue, but as it stands neuroendovascular robotic implementation is worth continued investigation.
Madder RDVSJacobyMECollinsJS, et al.Percutaneous coronary intervention using a combination of robotics and telecommunications by an operator in a separate physical location from the patient: an early exploration into the feasibility of telestenting (the REMOTE-PCI study). EuroIntervention2017; 12: 1569–1576.
2.
SajjaKCSweidAAl SaieghF, et al.Endovascular robotic: feasibility and proof of principle for diagnostic cerebral angiography and carotid artery stenting. J Neurointerv Surg2020; 12: 345–349. [published Online First: 2020/03/03].
3.
BritzGWTomasJLumsdenA. Feasibility of robotic-assisted neurovascular interventions: initial experience in flow model and porcine model. Neurosurgery2020; 86: 309–314. [published Online First: 2019/04/18].
4.
NogueiraRGSachdevaRAl-BayatiAR, et al.Robotic assisted carotid artery stenting for the treatment of symptomatic carotid disease: technical feasibility and preliminary results. J Neurointerv Surg2020; 12: 341–344. [published Online First: 2020/03/03].
WeiszGMetzgerDCCaputoRP, et al.Safety and feasibility of robotic percutaneous coronary intervention: PRECISE (percutaneous robotically-enhanced coronary intervention) study. J Am Coll Cardiol2013; 61: 1596–1600. [published Online First: 2013/03/19].
7.
HiraiTKearneyKKatarukaA, et al.Initial report of safety and procedure duration of robotic-assisted chronic total occlusion coronary intervention. Catheter Cardiovasc Interv2020; 95: 165–169. [published Online First: 2019/09/05].
8.
GranadaJFDelgadoJAUribeMP, et al.First-in-human evaluation of a novel robotic-assisted coronary angioplasty system. JACC Cardiovasc Interv2011; 4: 460–465. [published Online First: 2011/04/23].
9.
MahmudENaghiJAngL, et al.Demonstration of the safety and feasibility of robotically assisted percutaneous coronary intervention in Complex coronary lesions: results of the CORA-PCI study (Complex robotically assisted percutaneous coronary intervention). JACC Cardiovasc Interv2017; 10: 1320–1327. [published Online First: 2017/07/08].
10.
WaltersDReevesRRPatelM, et al.Complex robotic compared to manual coronary interventions: 6- and 12-month outcomes. Catheter Cardiovasc Interv2019; 93: 613–617. [published Online First: 2018/11/21].
11.
HarrisonJAngLNaghiJ, et al.Robotically-assisted percutaneous coronary intervention: reasons for partial manual assistance or manual conversion. Cardiovasc Revasc Med2018; 19: 526–531. [published Online First: 2017/12/10].
12.
MadderRDVanOosterhoutSMulderA, et al.Feasibility of robotic telestenting over long geographic distances: a pre-clinical ex vivo and in vivo study. EuroIntervention2019; 15: e510–ee12. [published Online First: 2019/04/17].
13.
MahmudESchmidFKalmarP, et al.Feasibility and safety of robotic peripheral vascular interventions: results of the RAPID trial. JACC Cardiovasc Interv2016; 9: 2058–2064. [published Online First: 2016/09/19].
14.
PatelTShahSRanjanA, et al.Contralateral transradial approach for carotid artery stenting: a feasibility study. Catheter Cardiovasc Interv2010; 75: 268–275.
15.
SmilowitzNRMosesJWSosaFA, et al.Robotic-Enhanced PCI compared to the traditional manual approach. J Invasive Cardiol2014; 26: 318–321. [published Online First: 2014/07/06].
16.
SmitsonCCAngLPourdjabbarA, et al.Safety and feasibility of a novel, second-generation robotic-assisted system for percutaneous coronary intervention: first-in-human report. J Invasive Cardiol2018; 30: 152–156. [published Online First: 2018/01/18].
ShamseerLMoherDClarkeM, et al.Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. Br Med J2015; 350: g7647. [published Online First: 2015/01/04].
19.
BeyarRGrubergLDeleanuD, et al.Remote-control percutaneous coronary interventions: concept, validation, and first-in-humans pilot clinical trial. J Am Coll Cardiol2006; 47: 296–300. [published Online First: 2006/01/18].
20.
HooshiarANajarianSDargahiJ. Haptic telerobotic cardiovascular intervention: a review of approaches, methods, and future perspectives. IEEE Rev Biomed Eng2020; 13: 32–50. [published Online First: 2019/04/05].
21.
BritzGWPanesarSSFalbP, et al.Neuroendovascular-specific engineering modifications to the CorPath GRX robotic system. J Neurosurg2019; 133: 1830–1836. [published Online First: 2019/11/30].
22.
LuWSXuWYPanF, et al.Clinical application of a vascular interventional robot in cerebral angiography. Int J Med Robot2016; 12: 132–136. [published Online First: 2015/03/18].
23.
Wang KCBLuQ, et al.Design and performance evaluation of real-timeendovascular interventional surgical robotic system with high accuracy. Int J Med Robotics Comput Assist Surg2018; 14: 1915.
24.
Guo JGSXiaoN, et al.A novel robotic catheter system with force and visual feedback for vascular interventional surgery. International Journal of Mechatronics and Automation2012; 2: 15–24.
25.
Al Nooryani AAW. Rotate-on-retract procedural automation for robotic-assisted percutaneous coronary intervention: first clinical experience. Case Rep Cardiol2018; 2018: 6086034. doi: 10.1155/2018/6086034.
26.
BezerraHGMehanna EGWV, et al.Longitudinal geographic miss (LGM) in robotic assisted versus manual percutaneous coronary interventions. J Interv Cardiol2015; 28: 449–455. [published Online First: 2015/10/23].
27.
CampbellPTKruseKRKrollCR, et al.The impact of precise robotic lesion length measurement on stent length selection: ramifications for stent savings. Cardiovasc Revasc Med2015; 16: 348–350. [published Online First: 2015/08/04].
28.
LevyEIBoulosASHanelRA, et al.In vivo model of intracranial stent implantation: a pilot study to examine the histological response of cerebral vessels after randomized implantation of heparin-coated and uncoated endoluminal stents in a blinded fashion. J Neurosurg2003; 98: 544–553. [published Online First: 2003/03/26].
29.
NikolskyE PTMehranRBalterS, et al.An evaluation of fluroscopy time and correlation with outcomes after percutaneous coronary intervention. J Invasive Cardiol2007; 19: 208.
30.
DouKFSongCXMuCW, et al.Feasibility and safety of robotic PCI in China: first in man experience in Asia. J Geriatr Cardiol2019; 16: 401–405. [published Online First: 2019/06/21].
31.
BezerraHGSimonDI. Robotic percutaneous coronary intervention: time to focus on the patient. JACC: Cardiovascular Interventions2017; 10: 1328–1331. [published Online First: 2017/07/08].
32.
PanesarSSVolpiJJLumsdenA, et al.Telerobotic stroke intervention: a novel solution to the care dissemination dilemma. J Neurosurg2019; 132: 971–978. [published Online First: 2019/11/30]. doi: 10.3171/2019.8.JNS191739.
33.
HasanFBonattiJ. Robotically assisted percutaneous coronary intervention: benefits to the patient and the cardiologistExpert Rev Cardiovasc Ther2015; 13: 1165–1168. [published Online First: 2015/09/18].
34.
PatelTMShahSCPancholySB. Long distance tele-robotic-assisted percutaneous coronary intervention: a report of first-in-human experience. EClinicalMedicine2019; 14: 53–58. [published Online First: 2019/11/12].
35.
MadderRDVanOosterhoutSMulderA, et al.Network latency and long-distance robotic telestenting: exploring the potential impact of network delays on telestenting performance. Catheter Cardiovasc Interv2020; 95: 914–919. [published Online First: 2019/08/15].
36.
BechsteinMBuhkJHFrolichAM, et al.Training and supervision of thrombectomy by remote live streaming support (RESS): randomized comparison using simulated stroke interventions. Clin Neuroradiol2019; 31: 181–187. [published Online First: 2019/12/22].
37.
NogueiraRGSachdevaRAl-BayatiAR, et al.Robotic assisted carotid artery stenting for the treatment of symptomatic carotid disease: technical feasibility and preliminary results. J Neurointerv Surg2020; 12: 341–344. [published Online First: 2020/03/03].
38.
VuongSMCarrollCPTacklaRD, et al.Application of emerging technologies to improve access to ischemic stroke care. Neurosurg Focus2017; 42: E8. [published Online First: 2017/04/04].
39.
SajjaKCSweidAAl SaieghF, et al.Endovascular robotic: feasibility and proof of principle for diagnostic cerebral angiography and carotid artery stenting. J Neurointerv Surg2020; 12: 345–349. [published Online First: 2020/03/03].
40.
GhasemASharmaAGreifDN, et al.The arrival of robotics in spine surgery: a review of the literature. Spine (Phila Pa 1976)2018; 43: 1670–1677. [published Online First: 2018/04/20].
41.
AllencherrilJHymanDLoyaA, et al.Outcomes of robotically assisted versus manual percutaneous coronary intervention: a systematic review and meta-analysis. J Invasive Cardiol2019; 31: 199–203. [published Online First: 2019/05/16].
42.
MenakerSAShahSSSnellingBM, et al.Current applications and future perspectives of robotics in cerebrovascular and endovascular neurosurgery. J Neurointerv Surg2018; 10: 78–82. [published Online First: 2017/08/20].
43.
Nelson JTBN. The delivery of stroke intervention in the community: is telerobotic endovascular surgery the solution?J Neurosurg2019; 1: 1–3.
44.
CumminsPBruiningN. Robot-assisted telestenting: brightening the light of science. EuroIntervention2017; 12: 1561–1563. [published Online First: 2017/01/21].
45.
Madhavan KKJChiengLOWangMY. Augmented-reality integrated robotics in neurosurgery: are we there yet?Neurosurg Focus2017; 42: E3.
46.
JiangYLiuKLiY. Initial clinical trial of robot of endovascular treatment with force feedback and cooperating of catheter and guidewire. Appl Bionics Biomech2018; 2018: 9735979. [published Online First: 2018/06/01].
47.
ZamoranoLLiQJainS, et al.Robotics in neurosurgery: state of the art and future technological challenges. Int J Med Robot2004; 1: 7–22. [published Online First: 2007/05/24].
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
