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Cited by 422

The DOI matches its Crossref record; 37 of the 37 references it cites were found in a registry or an index.

Telerobotic neurovascular interventions with magnetic manipulation

Open access
Kim, Yoonho, Genevriere, Emily, Harker, Pablo, Choe, Jaehun, Balicki, Marcin, Regenhardt, Robert W., Vranic, Justin E., Dmytriw, Adam A., Patel, Aman B., Zhao, Xuanhe·2022·Science Robotics
DOI 10.1126/scirobotics.abg9907
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Abstract

Advances in robotic technology have been adopted in various subspecialties of both open and minimally invasive surgery, offering benefits such as enhanced surgical precision and accuracy with reduced fatigue of the surgeon. Despite the advantages, robotic applications to endovascular neurosurgery have remained largely unexplored because of technical challenges such as the miniaturization of robotic devices that can reach the complex and tortuous vasculature of the brain. Although some commercial systems enable robotic manipulation of conventional guidewires for coronary and peripheral vascular interventions, they remain unsuited for neurovascular applications because of the considerably smaller and more tortuous anatomy of cerebral arteries. Here, we present a teleoperated robotic neurointerventional platform based on magnetic manipulation. Our system consists of a magnetically controlled guidewire, a robot arm with an actuating magnet to steer the guidewire, a set of motorized linear drives to advance or retract the guidewire and a microcatheter, and a remote-control console to operate the system under real-time fluoroscopy. We demonstrate our system’s capability to navigate narrow and winding pathways both in vitro with realistic neurovascular phantoms representing the human anatomy and in vivo in the porcine brachial artery with accentuated tortuosity for preclinical evaluation. We further demonstrate telerobotically assisted therapeutic procedures including coil embolization and clot retrieval thrombectomy for treating cerebral aneurysms and ischemic stroke, respectively. Our system could enable safer and quicker access to hard-to-reach lesions while minimizing the radiation exposure to physicians and open the possibility of remote procedural services to address challenges in current stroke systems of care.

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Metadata

Authors
Kim, Y., Genevriere, E., Harker, P., Choe, J., Balicki, M., Regenhardt, R. W., Vranic, J. E., Dmytriw, A. A., Patel, A. B., & Zhao, X.
Venue
Science Robotics
Publisher
American Association for the Advancement of Science (AAAS)
Published
2022-04-27
Volume
7
Issue
65
Pages
eabg9907-eabg9907
ISSN
2470-9476 (ISSN-L)
DOI
10.1126/scirobotics.abg9907
OpenAlex
W4223931121
Cited by
422
References
37
FWCI
39.23
Type
journal article
Language
en
Open access
green

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