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

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.