Telerobotic neurovascular interventions with magnetic manipulation
Name
nihms-1812742.pdf
Description
Accepted version
Size
3.06 MB
Format
Adobe PDF
Checksum (MD5)
a6204d3a11068d6130ae111c739f891e
Author(s)
Kim, Yoonho
Genevriere, Emily
Harker, Pablo
Choe, Jaehun
Balicki, Marcin
Regenhardt, Robert W
Vranic, Justin E
Dmytriw, Adam A
Patel, Aman B
Zhao, Xuanhe
Date Issued
April 27, 2022
Journal
Science Robotics
Publisher
American Association for the Advancement of Science (AAAS)
Citation
Kim, Yoonho, Genevriere, Emily, Harker, Pablo, Choe, Jaehun, Balicki, Marcin et al. 2022. "Telerobotic neurovascular interventions with magnetic manipulation." Science Robotics, 7 (65).
Version
Author's final manuscript
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.
MIT Department
Massachusetts Institute of Technology. Department of Mechanical Engineering
Terms of Use
Creative Commons Attribution-Noncommercial-Share Alike
Persistent DSpace Link
DOI of Published Version
https://doi.org/10.1126/scirobotics.abg9907
