Robotics in Cerebrovascular Disease: The Final Frontier

Cerebrovascular disease remains a leading cause of global mortality. While endovascular therapies like mechanical thrombectomy and aneurysm coiling have revolutionized management, manual techniques are limited by operator fatigue, tremor, and occupational radiation exposure. This review examines the current state of robotics in neuroendovascular surgery. FDA-approved systems demonstrate safety and technical feasibility, achieving high success rates (94-100%) in aneurysm coiling and carotid stenting while significantly reducing operator radiation exposure (60-80%). In ischemic stroke, preclinical and recent clinical milestones, including the first fully remote, in-human diagnostic angiogram and transcontinental thrombectomy simulations, validate the feasibility of long-distance tele-interventions. Robotics in cerebrovascular management is rapidly evolving from a novel adjunct to clinical reality. Although challenges regarding cost, haptic feedback, and training persist, next-generation platforms integrating artificial intelligence and magnetic navigation hold the potential to overcome these barriers, establishing remote telerobotic networks to expand access to time-critical stroke care.