Modeling Robotic-Assisted Mechanical Thrombectomy Procedures with the CorPath GRX Robot : The Core-Flow Study
Tomasello, Alejandro (Universitat Autònoma de Barcelona. Departament de Medicina)
Hernández, David (Hospital del Mar (Barcelona, Catalunya))
Li, Jiahui (Universitat Autònoma de Barcelona. Departament de Medicina)
Tiberi, Riccardo (Universitat Autònoma de Barcelona. Departament de Medicina)
Rivera, Eila (Hospital Universitari Vall d'Hebron)
Vargas, Joan Daniel (Hospital Universitari Vall d'Hebron)
Losada, Cristina (Hospital Universitari Vall d'Hebron)
Jablonska, Magda (Hospital Universitari Vall d'Hebron)
Esteves, Marielle (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Diaz, Maria Lourdes (Hospital Arnau de Vilanova (Lleida, Catalunya))
Cendrero Correa, Judith (Universitat Autònoma de Barcelona. Departament de Medicina)
Requena, Manuel (Hospital Universitari Vall d'Hebron)
Diana, Francesco (Hospital Universitari Vall d'Hebron)
De Dios, Marta (Hospital Universitari Vall d'Hebron)
Singh, Trisha (Hospital Universitari Vall d'Hebron)
Gramegna, Laura Ludovica (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Ribo, Marc (Hospital Universitari Vall d'Hebron)

Fecha:	2024
Resumen:	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.
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Lengua:	Anglès
Documento:	Article ; recerca ; Versió acceptada per publicar
Publicado en:	American Journal of Neuroradiology, Vol. 45, Núm. 6 (June 2024) , p. 721-726, ISSN 1936-959X

DOI: 10.3174/ajnr.A8205
PMID: 38663990

Postprint 18 p, 342.7 KB

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