Abstract Number ‐ 204: Robotics in Neuro‐Endovascular Field: Back to the Future
Introduction For more than three decades, robotic assisted surgery has been proposed, studied and put into action clinically. Likewise, it was cleared by the Food and Drug Administration for percutaneous coronary intervention in 2012 (K120834) and peripheral vascular intervention including carotid i...
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| Format: | Article |
| Language: | English |
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Wiley
2023-03-01
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| Series: | Stroke: Vascular and Interventional Neurology |
| Online Access: | https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.204 |
| _version_ | 1797803538898747392 |
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| author | Mohamed F Doheim Mohamed Abdelhady Mostafa Mohamed Elfil Abdallah Kamal |
| author_facet | Mohamed F Doheim Mohamed Abdelhady Mostafa Mohamed Elfil Abdallah Kamal |
| author_sort | Mohamed F Doheim |
| collection | DOAJ |
| description | Introduction For more than three decades, robotic assisted surgery has been proposed, studied and put into action clinically. Likewise, it was cleared by the Food and Drug Administration for percutaneous coronary intervention in 2012 (K120834) and peripheral vascular intervention including carotid intervention in 2018 (K173288), but has not yet received clearance for intracranial neurovascular intervention in the USA. Recently, several pilot clinical studies assessed robotically performed neurointerventions. Methods We performed comprehensive electronic search till July 2022 on PubMed/Medline to retrieve all relevant studies and data were extracted for baseline characteristics, design, procedure type, safety and feasibility outcomes for qualitative synthesis. Results Our results yielded nine single center studies in UK, USA and China performed since 2015. The performed procedures included diagnostic cerebral angiography (36 patients), caroti aartery stenting (37 patients), unspecified robotic assisted intracranial intervention (18 patients) and stent‐assisted coil embolization of a basilar artery aneurysm (one case). The used robotic systems included Corpath GRX (5 studies), Magellan (2 studies), RobEnt (one study) and VIR‐2 (one study). The robotic assisted neurointervention was successful clinically without complications across all studies and for all procedures. The learning curve sounded promising but there were limitations in the design of systems for completing all steps robotically. Conclusions Robotics assisted procedures appear to be feasible and safe in neuro‐intevention field. Advantages include high accuracy, stability, safety, simplicity, versatility, monitoring, endothelial protection, and potential for remote access for procedures such as mechanical thrombectomy for acute ischemic stroke. However, there are many challenges including cost, manual steps, lack of manual resistance feeling, irrationality in the spatial arrangement of the robotic system and operating table. Additionally, most of the included studies were retrospective with small sample size and short term follow up and more well‐designed comparative prospective studies are needed to confirm these results. |
| first_indexed | 2024-03-13T05:22:22Z |
| format | Article |
| id | doaj.art-8559fa14d0614e9e97ff138da13729d4 |
| institution | Directory Open Access Journal |
| issn | 2694-5746 |
| language | English |
| last_indexed | 2024-03-13T05:22:22Z |
| publishDate | 2023-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke: Vascular and Interventional Neurology |
| spelling | doaj.art-8559fa14d0614e9e97ff138da13729d42023-06-15T10:40:49ZengWileyStroke: Vascular and Interventional Neurology2694-57462023-03-013S110.1161/SVIN.03.suppl_1.204Abstract Number ‐ 204: Robotics in Neuro‐Endovascular Field: Back to the FutureMohamed F Doheim0Mohamed Abdelhady Mostafa1Mohamed Elfil2Abdallah Kamal3UPMC Stroke Institute, Departments of Neurology University of Pittsburgh Pittsburgh Pennsylvania United States of AmericaParadise Neurology and Rehabilitation Clinics Alexandria EgyptDepartment of Neurological Sciences University of Nebraska Medical Center Omaha United States of AmericaHillman Cancer Center, University of Pittsburgh Medical Center Pittsburgh United States of AmericaIntroduction For more than three decades, robotic assisted surgery has been proposed, studied and put into action clinically. Likewise, it was cleared by the Food and Drug Administration for percutaneous coronary intervention in 2012 (K120834) and peripheral vascular intervention including carotid intervention in 2018 (K173288), but has not yet received clearance for intracranial neurovascular intervention in the USA. Recently, several pilot clinical studies assessed robotically performed neurointerventions. Methods We performed comprehensive electronic search till July 2022 on PubMed/Medline to retrieve all relevant studies and data were extracted for baseline characteristics, design, procedure type, safety and feasibility outcomes for qualitative synthesis. Results Our results yielded nine single center studies in UK, USA and China performed since 2015. The performed procedures included diagnostic cerebral angiography (36 patients), caroti aartery stenting (37 patients), unspecified robotic assisted intracranial intervention (18 patients) and stent‐assisted coil embolization of a basilar artery aneurysm (one case). The used robotic systems included Corpath GRX (5 studies), Magellan (2 studies), RobEnt (one study) and VIR‐2 (one study). The robotic assisted neurointervention was successful clinically without complications across all studies and for all procedures. The learning curve sounded promising but there were limitations in the design of systems for completing all steps robotically. Conclusions Robotics assisted procedures appear to be feasible and safe in neuro‐intevention field. Advantages include high accuracy, stability, safety, simplicity, versatility, monitoring, endothelial protection, and potential for remote access for procedures such as mechanical thrombectomy for acute ischemic stroke. However, there are many challenges including cost, manual steps, lack of manual resistance feeling, irrationality in the spatial arrangement of the robotic system and operating table. Additionally, most of the included studies were retrospective with small sample size and short term follow up and more well‐designed comparative prospective studies are needed to confirm these results.https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.204 |
| spellingShingle | Mohamed F Doheim Mohamed Abdelhady Mostafa Mohamed Elfil Abdallah Kamal Abstract Number ‐ 204: Robotics in Neuro‐Endovascular Field: Back to the Future Stroke: Vascular and Interventional Neurology |
| title | Abstract Number ‐ 204: Robotics in Neuro‐Endovascular Field: Back to the Future |
| title_full | Abstract Number ‐ 204: Robotics in Neuro‐Endovascular Field: Back to the Future |
| title_fullStr | Abstract Number ‐ 204: Robotics in Neuro‐Endovascular Field: Back to the Future |
| title_full_unstemmed | Abstract Number ‐ 204: Robotics in Neuro‐Endovascular Field: Back to the Future |
| title_short | Abstract Number ‐ 204: Robotics in Neuro‐Endovascular Field: Back to the Future |
| title_sort | abstract number 204 robotics in neuro endovascular field back to the future |
| url | https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.204 |
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