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Modeling Robotic-Assisted Mechanical Thrombectomy Procedures with the CorPath GRX Robot: The Core-Flow Study.
Alejandro Tomasello1,2, David Hernández3, Jiahui Li4
1From the Interventional Neuroradiology Section (A.T., D.H., J.D.V., C.L., M. Requena, F.D., M.D.D., T.S.), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain. alejandrotomasello@gmail.com.
AJNR. American Journal of Neuroradiology
|April 25, 2024
Summary
Robot-assisted endovascular thrombectomy shows potential for comparable recanalization rates to manual methods in stroke treatment. Further optimization is needed before clinical application of this robotic approach.
Area of Science:
- Neurosurgery
- Medical Robotics
- Endovascular Therapy
Background:
- Endovascular robotic devices offer potential for remote endovascular thrombectomy by neurointerventionalists.
- Assessing robot-assisted thrombectomy against manual procedures is crucial for evaluating new stroke treatments.
Purpose of the Study:
- To evaluate the feasibility, safety, and efficacy of robot-assisted versus manual endovascular thrombectomy.
- To compare outcomes across operators with varying experience levels using a 3D neurovascular model.
Main Methods:
- Simulated M1 MCA occlusions in a 3D printed neurovascular model connected to a CorPath GRX robot.
- Four interventionalists performed 45 manual and 37 robot-assisted thrombectomies.
- Key outcomes: first-pass recanalization (TICI 2c-3), emboli generation, and procedure length.
Main Results:
- Robot-assisted thrombectomy showed a trend towards higher recanalization rates (89.2% vs. 71.1%, P=.083).
- No significant difference in total emboli count, but more large emboli (>1 mm) with robotic assistance (P=.001).
- Robot-assisted procedures were significantly longer (6.43 min vs. 3.98 min, P<.001).
Conclusions:
- Robot-assisted endovascular thrombectomy may achieve recanalization rates comparable to manual methods.
- Procedural times for robotic assistance require optimization for clinical readiness.
- The technology shows promise but needs further refinement before widespread clinical adoption.
