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Robotic assisted carotid artery stenting for the treatment of symptomatic carotid disease: technical feasibility and preliminary results
  1. Raul G Nogueira1,2,
  2. Rajesh Sachdeva2,3,
  3. Alhamza R Al-Bayati1,2,
  4. Mahmoud H Mohammaden1,2,
  5. Michael R Frankel1,2,
  6. Diogo C Haussen1,2
  1. 1 Department of Neurology, Marcus Stroke & Neuroscience Center, Emory University School of Medicine, Atlanta, Georgia, USA
  2. 2 Grady Memorial Hospital, Atlanta, Georgia, USA
  3. 3 Department of Cardiology, Morehouse University School of Medicine, Atlanta, Georgia, USA
  1. Correspondence to Dr Raul G Nogueira, Department of Neurology, Marcus Stroke & Neuroscience Center, Emory University School of Medicine, Atlanta, GA 30303, USA; raul.g.nogueira{at}emory.edu

Abstract

Background and purpose Robotic-assisted endovascular interventions have been increasingly performed in the coronary and peripheral vascular beds. We aim to describe the feasibility and initial safety of a robotic-assisted platform for treating carotid artery disease.

Methods Single-center technical report of the first four consecutive cases of carotid artery stenting for the treatment of severe symptomatic carotid stenosis utilizing the CorPath GRX Robotic System (Corindus Inc, Waltham, MA).

Results Four patients (one in early 60s and three in early 70s; NASCET degree of stenosis: 88%, 77%, 83% and 82%) with ipsilateral strokes on presentation were treated. All steps of the procedure (including delivery/removal of micro-guidewire, emboli-protection system and angioplasty balloon) could be successfully performed robotically with the exception of navigation/deployment of the stents due to incompatibility with the current robotic platform. Technical success was achieved in all patients resulting in resolution of the stenosis without any complications.

Conclusions Robotic-assisted carotid artery stenting is technically feasible. Future studies are warranted to properly establish safety and benefits.

  • stenosis
  • stent
  • stroke
  • technique
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Footnotes

  • Contributors RGN: Study conception, design of the work, acquisition of data, interpretation of data, drafting of the manuscript. RS: Data acquisition, critical revision of manuscript. ARA: Data acquisition, critical revision of manuscript. MHM: Critical revision of manuscript. MRF: Critical revision of manuscript. DCH: Acquisition of data, interpretation of data, drafting of the manuscript. All authors gave final approval of the version to be published, and are in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests RGN: Corindus Vascular Robotics (Physician Advisory Board, stock options). Unrelated to this research: RGN: Stryker Neurovascular (DAWN Trial Principal Investigator- no compensation, TREVO Registry Steering Committee – no compensation, Trevo-2 Trial Principal Investigator- modest; Consultant - significant); Medtronic (SWIFT Trial Steering Committee - modest; SWIFT-Prime Trial Steering Committee – no compensation; STAR Trial Angiographic Core Lab - significant); Penumbra (3D Separator Trial Executive Committee – no compensation); Cerenovus/ Neuravi (ENDOLOW Trial Principal Investigator, EXCELLENT Registry Principal Investigator, ARISE-2 trial Steering Committee – no compensation, Physician Advisory Board, modest); Phenox (PROST Trial Principal Investigator, Physician Advisory Board, modest); Anaconda (Physician Advisory Board, modest); Genentech (Physician Advisory Board – modest); Biogen (CHARM Trial Steering Committee; Physician Advisory Board – modest); Prolong Pharmaceuticals (Physician Advisory Board – modest); Allm Inc. (Physician Advisory Board – no compensation); IschemaView (Speaker, modest); Brainomix (Physician Advisory Board, stock options); Sensome (Research Device Use – no compensation); Viz-AI (Physician Advisory Board, stock options); Philips (Research Software Use – no compensation, Speaker - modest); Vesalio (Physician Advisory Board, stock options); Ceretrieve (Physician Advisory Board, stock options); Astrocyte (Physician Advisory Board, stock options). DCH: Consultant for Stryker and Vesalio, Viz-AI (stock options).

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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