Article Text

Download PDFPDF
Case series
Real time artificial intelligence assisted carotid artery stenting: a preliminary experience
  1. Yuya Sakakura1,
  2. Kenichi Kono2,3,
  3. Takeshi Fujimoto4
  1. 1Department of Neurosurgery, NTT Medical Center Tokyo, Tokyo, Japan
  2. 2Department of Neurosurgery, Showa University Fujigaoka Hospital, Kanagawa, Japan
  3. 3iMed Technologies, Tokyo, Japan
  4. 4Department of Neurosurgery, Numata Neurosurgery and Cardiovascular Hospital, Gunma, Japan
  1. Correspondence to Dr Yuya Sakakura, Department of Neurosurgery, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo 141-8625, Japan; yuya.sakakura{at}


Background Neurointerventionalists must pay close attention to multiple devices on multiple screens simultaneously, which can lead to oversights and complications. Artificial intelligence (AI) has potential application in recognizing and monitoring these devices on fluoroscopic imaging.

Methods We report out preliminary experience with a real time AI assistance software, Neuro-Vascular Assist (iMed technologies, Tokyo, Japan), in six patients who underwent carotid artery stenting. This software provides real time assistance during endovascular procedures by tracking wires, guiding catheters, and embolic protection devices. The software provides notification when devices move out of a predefined region of interest or off the screen during the procedure. Efficacy, safety, and accuracy of the software were evaluated.

Results The software functioned well without problems and was easily used. Mean number of notifications per procedure was 21.0. The mean numbers of true positives, false positives, and false negatives per procedure were 17.2, 3.8, and 1.2, respectively. Precision and recall were 82% and 94%, respectively. Among the 103 true positive notifications, 24 caused the operator to adjust the inappropriate position of the device (23%), which is approximately four times per procedure. False notifications occurred because of false positive device detection. No adverse events related to the software occurred. No periprocedural complications occurred.

Conclusions Neuro-Vascular Assist, a real time AI assistance software, worked appropriately and may be beneficial in carotid artery stenting procedures. Future large scale studies are warranted to confirm.

  • Stenosis
  • guidewire
  • Angioplasty
  • Cervical
  • Technology

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • X @CeoImed

  • Contributors KK conceived the idea of the study. YS and KK contributed to the interpretation of the results. YS drafted the original manuscript. KK and TF supervised the conduct of this study. All authors reviewed the manuscript draft and revised it critically for intellectual content. All authors approved the final version of the manuscript to be published.

  • 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 YS received honoraria from iMed Technologies. KK is a CEO and holds shares in iMed Technologies.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.