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New Devices and Techniques
Endovascular robotic: feasibility and proof of principle for diagnostic cerebral angiography and carotid artery stenting
  1. Kalyan Chekravarthy Sajja1,
  2. Ahmad Sweid2,
  3. Fadi Al Saiegh1,
  4. Nohra Chalouhi3,
  5. Michael B Avery1,
  6. Richard F Schmidt1,
  7. Stavropoula I Tjoumakaris2,
  8. Michael Reid Gooch2,
  9. Nabeel Herial2,
  10. Rawad Abbas4,
  11. Hekmat Zarzour2,
  12. Victor Romo2,
  13. Robert Rosenwasser3,
  14. Pascal Jabbour2
  1. 1 Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
  2. 2 Department of Neurological surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
  3. 3 Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
  4. 4 School of Medicine, American University of Beirut, Beirut, Lebanon
  1. Correspondence to Dr Pascal Jabbour, Department of Neurological surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA; pascal.jabbour{at}jefferson.edu

Abstract

Background Robots in surgery aid in performing delicate, precise maneuvers that humans, with inherent physical abilities, may be limited to perform. The CorPath 200 system is FDA approved and is being implemented in the US for interventional cardiology procedures. CorPath GRX robotic-assisted platform is the next-generation successor of CorPath 200.

Objective To discuss the feasibility and early experience with the use of the CorPath GRX robotic-assisted platform for neuroendovascular procedures, including transradial diagnostic cerebral angiograms and transradial carotid artery stenting.

Methods The cases of 10 consecutive patients who underwent neuroendovascular robotic-assisted procedures between December 1, 2019 and December 30, 2019, are presented.

Results Seven patients underwent elective diagnostic cerebral angiography, and three patients underwent carotid artery angioplasty and stenting using the CorPath GRX robotic-assisted platform. All procedures were performed successfully, and no complications were encountered. Conversion to manual control occurred in three diagnostic cases because of a bovine arch that was previously not known. The fluoroscopy time and the procedure time continued to improve with subsequent procedures as we streamlined the workflow.

Conclusion This series demonstrates the early use of this technology. It could potentially be used in the near future for acute stroke interventions in remote geographic locations and in places where a neurointerventionalist is not available.

  • aneurysm
  • angiography
  • device
  • intervention
  • stroke

https://doi.org/10.1136/neurintsurg-2019-015763

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    Footnotes

    • Twitter @PascalJabbourMD

    • Contributors KCS, AS, FAS, NC, PJ drafted the manuscript and revised the manuscript for important intellectual content. RFS, MBA, RA assisted with data acquisition and analysis. HZ, VR, KCS, PJ reviewed the important intellectual content presented in the manuscript. SIT, MRG, NH, RR, PJ performed the treatment procedures and critically revised the important intellectual content. All authors read and approved the final manuscript.

    • 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 PJ is a consultant for Medtronic and MicroVention. SIT is a consultant for Stryker.

    • Patient consent for publication Not required.

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

    • Data availability statement Data are available upon reasonable request.

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