Remote robotic endovascular thrombectomy for acute ischaemic stroke

Area of Science:

• Neurosurgery
• Medical Robotics
• Vascular Interventions

Background:

• Endovascular thrombectomy (ET) is crucial for acute ischemic stroke but has limited access.
• Telerobotic technology may bridge this gap by disseminating neurosurgical expertise.
• Remote robotic ET (RRET) explores collaborative offsite and onsite telerobotic procedures.

Purpose of the Study:

• To evaluate the technical feasibility of RRET.
• To demonstrate a collaborative RRET procedure using telerobotics.

Main Methods:

• An ex vivo model simulating RRET was established with a 5-mile network connection.
• An offsite neurosurgeon controlled robotic equipment.
• An onsite interventional cardiologist provided assistance in a simulation laboratory.

Main Results:

• The neurosurgeon successfully navigated a guidewire to simulated thrombus in the middle cerebral artery (MCA).
• The cardiologist advanced an aspiration catheter and removed the guidewire.
• Aspiration was successfully performed under remote guidance.

Conclusions:

• RRET is technically feasible in an ex vivo model.
• Collaboration between offsite neurosurgeons and onsite cardiologists is effective in RRET.
• Future studies should investigate RRET's potential to improve ET access for stroke patients.