Current utilization and future directions of robotic-assisted endovascular surgery

ABSTRACT

Introduction

Endovascular surgery has become the standard of care to treat most vascular diseases using a minimally invasive approach. The CorPath system further enhances the potential and enables surgeons to perform robotic-assisted endovascular procedures in interventional cardiology, peripheral vascular surgery, and neurovascular surgery. With the introduction of this technique, the operator can perform multiple steps of endovascular interventions outside of the radiation field with high precision movements even from long-geographical distances.

Areas covered

The first and second-generation CorPath systems are currently the only commercially available robotic devices for endovascular surgery. This review article discusses the clinical experiences and outcomes with the robot, the advanced navigational features, and the results with recent hardware and software modifications, which enables the use of the system for neurovascular interventions, and long-distance interventional procedures.

Expert opinion

A high procedural success was achieved with the CorPath robotic systems in coronary and peripheral interventions, and the device seems promising in neurovascular procedures. More experience is needed with robotic neurovascular interventions and with complex peripheral arterial cases. In the future, long-distance endovascular surgery can potentially transform the management and treatment of acute myocardial infarction and stroke, with making endovascular care more accessible for patients in remote areas.

KEYWORDS:

• Robotic-surgery
• endovascular robotics
• radiation protection
• CorPath
• remote surgery
• tele-stenting

Article highlights

• The CorPath robotic system is designed for robotic-assisted endovascular interventions

• The second-generation CorPath GRX is compatible with 0.014-inch guidewires, rapid exchange devices and with 5-7 Fr guide catheters

• Movements as guidewire and guide catheter advancement, retraction and rotation can be performed by joysticks, while the rapid exchange device can be advanced or retracted

• Navigational features include automatic wire rotations (‘rotate on retract’), and automatic device fixation for separate manipulation of the guidewire and the catheter

• Clinical evidence describes a high technical success rate with percutaneous coronary and peripheral vascular interventions, and the modified CorPath GRX is showing promising results with neurovascular interventions

• Feasibility studies have reported successful long-distance robotic-assisted endovascular interventions with the robot

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Information resources

Training materials for interventional physicians: https://www.roboticpci.com/user-resources/training-materials

Additional information

Funding

This paper was not funded.