RT Journal Article
SR Electronic
T1 Modeling Robotic-Assisted Mechanical Thrombectomy Procedures with the CorPath GRX Robot: The Core-Flow Study
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 721
OP 726
DO 10.3174/ajnr.A8205
VO 45
IS 6
A1 Tomasello, Alejandro
A1 Hernández, David
A1 Li, Jiahui
A1 Tiberi, Riccardo
A1 Rivera, Eila
A1 Vargas, Joan Daniel
A1 Losada, Cristina
A1 Jablonska, Magda
A1 Esteves, Marielle
A1 Diaz, Maria Lourdes
A1 Cendrero, Judith
A1 Requena, Manuel
A1 Diana, Francesco
A1 De Dios, Marta
A1 Singh, Trisha
A1 Gramegna, Laura Ludovica
A1 Ribo, Marc
YR 2024
UL http://www.ajnr.org/content/45/6/721.abstract
AB BACKGROUND AND PURPOSE: Endovascular robotic devices may enable experienced neurointerventionalists to remotely perform endovascular thrombectomy. This study aimed to assess the feasibility, safety, and efficacy of robot-assisted endovascular thrombectomy compared with manual procedures by operators with varying levels of experience, using a 3D printed neurovascular model.MATERIALS AND METHODS: M1 MCA occlusions were simulated in a 3D printed neurovascular model, linked to a CorPath GRX robot in a biplane angiography suite. Four interventionalists performed manual endovascular thrombectomy (n = 45) and robot-assisted endovascular thrombectomy (n = 37) procedures. The outcomes included first-pass recanalization (TICI 2c–3), the number and size of generated distal emboli, and procedural length.RESULTS: A total of 82 experimental endovascular thrombectomies were conducted. A nonsignificant trend favoring the robot-assisted endovascular thrombectomy was observed in terms of final recanalization (89.2% versus manual endovascular thrombectomy, 71.1%; P = .083). There were no differences in total mean emboli count (16.54 [SD, 15.15] versus 15.16 [SD, 16.43]; P = .303). However, a higher mean count of emboli of > 1 mm was observed in the robot-assisted endovascular thrombectomy group (1.08 [SD, 1.00] versus 0.49 [SD, 0.84]; P = .001) compared with manual endovascular thrombectomy. The mean procedural length was longer in robot-assisted endovascular thrombectomy (6.43 [SD, 1.71] minutes versus 3.98 [SD, 1.84] minutes; P < .001). Among established neurointerventionalists, previous experience with robotic procedures did not influence recanalization (95.8% were considered experienced; 76.9% were considered novices; P = .225).CONCLUSIONS: In a 3D printed neurovascular model, robot-assisted endovascular thrombectomy has the potential to achieve recanalization rates comparable with those of manual endovascular thrombectomy within competitive procedural times. Optimization of the procedural setup is still required before implementation in clinical practice.BGCballoon guide catheterEVTendovascular thrombectomyMAmanualMTmechanical thrombectomyRArobot-assistedSRstent retriever