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Comparing Manual and Robotic-Assisted Carotid Artery Stenting Using Motion-Based Performance Metrics.

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    Robotic assistance in carotid artery stenting (CAS) shows differences in surgical tool motion compared to manual methods. These quantitative differences in guidewire movement can help evaluate robotic systems in endovascular procedures.

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    Area of Science:

    • Endovascular surgery
    • Robotics in medicine
    • Medical simulation

    Background:

    • Carotid artery stenting (CAS) is a key treatment for carotid artery stenosis.
    • Robotic assistance offers potential benefits, reducing risks in CAS procedures.
    • Quantitative analysis of surgical tool motion is needed to verify robotic benefits.

    Purpose of the Study:

    • To quantitatively compare manual and robot-assisted navigation in CAS procedures.
    • To evaluate surgical navigation proficiency using specific performance metrics.
    • To analyze differences in guidewire tip motion between manual and robotic CAS.

    Main Methods:

    • Extracted guidewire tip motion profiles from recorded CAS procedure videos.
    • Computed spectral arc length (SPARC), average velocity, and idle time.
    • Analyzed metrics for two critical procedural steps on an endovascular surgical simulator.

    Main Results:

    • Significant differences in SPARC and idle time were found between manual and robot-assisted CAS.
    • Robot-assisted navigation showed a trend towards lower SPARC and average velocity.
    • Higher idle time was observed with robot-assisted navigation during sheath advancement.

    Conclusions:

    • Significant, quantifiable differences exist in tool motion between manual and robot-assisted CAS.
    • These granular-level motion differences aid in evaluating robotic assistance efficacy.
    • The findings support the growing clinical use of robotic systems in endovascular procedures.