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Neuroendovascular-specific engineering modifications to the CorPath GRX Robotic System.

Gavin W Britz1, Sandip S Panesar1, Peter Falb2

  • 11Department of Neurological Surgery and Neurological Institute, and.

Journal of Neurosurgery
|November 30, 2019
PubMed
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New robotic system modifications enhance safety and effectiveness for neurovascular interventions. This preclinical study shows improved device manipulation in complex cranial procedures, paving the way for specialized neurovascular robots.

Area of Science:

  • Biomedical Engineering
  • Neurosurgery
  • Medical Robotics

Background:

  • The CorPath GRX Robotic System, FDA-cleared for cardiovascular interventions, requires adaptation for neurovascular applications.
  • Neurovascular interventions demand high precision due to the delicate and tortuous anatomy of the cranial vasculature.
  • Existing robotic systems may lack the specific functionalities needed for complex neuroendovascular procedures.

Purpose of the Study:

  • To evaluate novel neuroendovascular-specific engineering and software modifications to the CorPath GRX Robotic System.
  • To assess the system's ability to support safer and more effective cranial neurovascular interventions in a preclinical model.
  • To determine if the modified system can improve navigation and manipulation of neurovascular instruments.

Main Methods:

Keywords:
cerebrovascular disordersendovascular proceduresminimally invasive surgical proceduresrobotic surgical procedurestherapeuticvascular disorders

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  • The CorPath GRX robot was modified with Active Device Fixation (ADF) software and a new drive cassette for neuroendovascular instruments.
  • A live porcine model with simulated neuroendovascular pathology was used for testing.
  • Robotic assistance was employed for endovascular procedures after manual femoral access, focusing on guidewire and microcatheter manipulation.

Main Results:

  • Successful navigation of the rete mirabile and an induced aneurysm in the common carotid artery.
  • Active Device Fixation (ADF) enabled independent guidewire and microcatheter movement, with controlled backward motion (1.5 mm) when active versus none when inactive.
  • The modified system demonstrated safe and effective manipulation of neurovascular guidewires and microcatheters, with no adverse events like dissection, extravasation, or thrombosis.

Conclusions:

  • Modifications significantly improved the CorPath GRX robot's utility for delicate neurovascular procedures.
  • The enhanced system offers improved control and safety in complex neuroendovascular environments.
  • These advancements lay the groundwork for developing a dedicated neurovascular robotic system.