Evaluating the CorPath GRX robotic system in cerebral aneurysm embolization and diagnostic angiography: a systematic...

The CorPath GRX robotic system has recently been extended from coronary interventions to neurovascular procedures, including cerebral aneurysm embolization and diagnostic cerebral angiography. However, current evidence consists predominantly of small-sample, single-arm studies, and quantitative synthesis of key outcomes-technical success, operative times, and radiation dose-with refinement by procedure type remains lacking. This study was guided by three prespecified research questions: (1) What is the pooled technical success rate of CorPath GRX-assisted cerebral aneurysm embolization and diagnostic angiography? (2) What are the pooled operative times and radiation doses associated with these procedures? (3) Do these outcomes differ significantly between embolization and angiography subgroups? We therefore conducted a systematic review and single-arm meta-analysis to evaluate the performance of the CorPath GRX system in these two core neurovascular applications. We systematically searched PubMed, Embase, Cochrane Library, and Web of Science up to May 1, 2026, for single-arm studies evaluating CorPath GRX-assisted neurovascular interventions. The primary outcomes were technical success rate, total procedural time, robotic operation time, fluoroscopy time, and radiation dose. A random-effects model was applied when substantial heterogeneity was present (I² ≥ 50%). Subgroup analyses were performed by procedure type (embolization vs. angiography), country/region, sample size, and study design. In the present evaluation, methodological rigor was assessed against the standards set forth in the JBI checklist for case series. Seven studies comprising 265 patients were included. The pooled technical success rate was 87% (95% CI: 75%-96%), with 94% (95% CI: 90%-96%, I² = 0.0%) in the embolization subgroup and 76% (95% CI: 63%-87%, I² = 69.4%) in the angiography subgroup. The pooled total procedural time, robotic operation time, and fluoroscopy time were 122.58 min (95% CI: 112.81-132.36), 60.68 min (95% CI: 44.40-76.97), and 30.70 min (95% CI: 18.99-42.41), respectively. The pooled radiation dose (three studies, air kerma) was 1,340.84 mGy (95% CI: 485.65-2,196.03), with high heterogeneity (I² = 97.0%). Subgroup analyses revealed that procedure type and study design significantly influenced operative times and technical success rate. JBI assessment identified six studies as high quality and one study as low quality This systematic review and single-arm meta-analysis provides preliminary, hypothesis-generating evidence that the CorPath GRX system is technically capable of performing both cerebral aneurysm embolization and diagnostic cerebral angiography in carefully selected patients, with encouraging performance observed in the embolization subgroup in early-stage experiences. However, all available evidence derives from small-sample, non-comparative, single-arm studies. The substantial heterogeneity across outcomes (I² > 60% for most endpoints) further underscores that these pooled estimates are exploratory and not definitive. The pooled radiation dose (based on only three studies with high heterogeneity) remains inconclusive. Robotic-assisted neurovascular procedures should therefore be regarded as a novel, technology-driven approach with demonstrated procedural feasibility in highly selected, early-stage clinical contexts, rather than an evidence-based standard of care. Future prospective, multicenter, comparative studies with standardized definitions and systematic reporting of learning curves and conversion rates are urgently needed to define its incremental clinical value.