(UPDATE: Interview Added) Robotics Offer Promise for Complex and Dangerous Endovascular Procedures

New research suggests a pioneering new robotic approach to treating blood vessels in the neck and brain is effective and safe.

The study, published in the Journal of NeuroInterventional Surgery, focused on the CorPath 200 system, which is currently approved in the United States for interventional procedures. Specifically, this research focused on whether the robotics were effective at being used in diagnostic cerebral angiograms and transradial carotid artery stenting. Patients living in remote geographic areas who suffer from strokes have further to travel for stroke intervention and have a critical loss in time in that window.

“These robots would allow us to intervene remotely on those patients,” lead author Pascal Jabbour, MD, chief of the Division of Neurovascular Surgery and Endovascular Neurosurgery at Thomas Jefferson University in Philadelphia, said in a press release. “The patient would still be in the community and I would be sitting here at Jefferson controlling the robot.”

The researchers included 10 consecutive patients undergoing neurovascular robotic-assisted procedures between December 2019 to December 2020. Of those, seven patients underwent elective diagnostic cerebral angiography, and three underwent carotid artery angioplasty and stenting with the CorPath GRX robotic-assisted platform. The authors reported procedural success with no complications. Three of the procedures switched over to manual operation due to bovine arches that were previously unknown. Fluoroscopy time and procedure times also continued to improve with subsequent procedures

Despite the small sample size, the study results, according to Dr. Jabbour, bode well for future applications of the technology in this clinical setting for these patients.

“The next generation of robots are ready to be launched and as soon as they are approved by the FDA we will be able to move to the next step, which is performing interventions inside the brain,” says Dr. Jabbour. “Jefferson will be on the front line of this technology, training the new generation of fellows on how to use these robots before any one else in the country.”

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UPDATE 3/4/20: Find below a DocWire News interview with Dr. Jabbour.

What prompted you to undertake this study?

We just acquired the endovascular robot and no one has ever done a transradial robotic carotid stents or cerebral angiograms. So we wanted, with this series, to try to get a proof of concept and show feasibility of those procedures robotic assisted.

What are some key takeaways?

The robot is user friendly, the cases were successfully performed, we can have a more accurate manipulation of catheters and wires as compared to manual, and we can do more tortuous cases. Another takeaway is that the physician has less exposure to radiation and doesn’t have to wear lead which put a stress on the spine.

Did any of the findings surprise you?

I was surprised how accurately we can manipulate catheters and wires.

What were some study limitations?

It’s a retrospective study and has a limited number of patients (only 10), but this was just a proof of concept/pilot study.

What is next for future research in the endovascular area?

Next, which is very exciting and in the near future, is to possibly do future remote stroke interventions on patients that are in far-off geographical areas, and in patients who can’t reach a comprehensive stroke center in a timely manner

Anything else to add?

We did the first transradial robotic stent in the country, and Jefferson has always been at the cutting edge of technology.

Congrats @KalyanSajja, @PascalJabbourMD, this has the potential to revolutionize stroke systems of care!
https://t.co/DQ3cdfvgzO

— UMN Cerebrovascular & Neurocritical Care (@umnstrokencc) March 3, 2020

Endovascular robotic: feasibility and proof of principle for diagnostic cerebral angiography and carotid artery stenting | Journal of NeuroInterventional Surgery https://t.co/Y2nxwckAKO

— NeuroIntact (@Neuro_Intact) March 2, 2020

http://twitter.com/MBludszuweit/statuses/1234440626634153984