Robotically-steerable catheters and their role in the visceral aortic segment

In recent years, steerable catheter systems have been introduced into clinical practice for cardiac mapping and ablation procedures. As endovascular therapy is becoming more complex, more advanced and versatile catheter designs utilizing robotic technology may have a role in aortic and peripheral arterial interventions. This article discusses alternative steerable catheter designs focusing on robotic endovascular catheter technology. A comprehensive comparison, review and analysis of robotic versus manual techniques in the visceral segment are presented to reveal both their advantages and limitations. Preclinical studies and early experience suggest that robotically steerable endovascular catheters offer improved manoeuvrability at the catheter tip, enhanced positional control and "off-the-wall" centreline navigation in a remote-control fashion. These advanced systems have the potential to overcome some of the technical difficulties with manual catheter control, improve stability at key target areas, reduce the risk of vessel trauma, distal embolization and radiation exposure, whilst improving overall operator performance with short learning curves. Robotic catheter technology may be more suitable to complex and often unpredictable anatomy in the visceral segment and may offer a reliable platform for future applications involving device delivery or target intervention. This intuitive technology is rapidly evolving and still requires technological refinements to extend current capabilities. Clinical studies involving head-to-head comparisons with conventional techniques are essential for evaluating its long-term safety and efficacy.