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Robotics in neurointerventional surgery: a systematic review of the literature

Research output: Contribution to journalArticlepeer-review

William Crinnion, Ben Jackson, Avnish Sood, Jeremy Lynch, Christos Bergeles, Hongbin Liu, Kawal Rhode, Vitor Mendes Pereira, Thomas Calvert Booth

Original languageEnglish
JournalJournal Of Neurointerventional Surgery
Early online date19 Nov 2021
DOIs
Accepted/In press24 Oct 2021
E-pub ahead of print19 Nov 2021

Bibliographical note

© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

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Abstract

BACKGROUND: Robotically performed neurointerventional surgery has the potential to reduce occupational hazards to staff, perform intervention with greater precision, and could be a viable solution for teleoperated neurointerventional procedures.

OBJECTIVE: To determine the indication, robotic systems used, efficacy, safety, and the degree of manual assistance required for robotically performed neurointervention.

METHODS: We conducted a systematic review of the literature up to, and including, articles published on April 12, 2021. Medline, PubMed, Embase, and Cochrane register databases were searched using medical subject heading terms to identify reports of robotically performed neurointervention, including diagnostic cerebral angiography and carotid artery intervention.

RESULTS: A total of 8 articles treating 81 patients were included. Only one case report used a robotic system for intracranial intervention, the remaining indications being cerebral angiography and carotid artery intervention. Only one study performed a comparison of robotic and manual procedures. Across all studies, the technical success rate was 96% and the clinical success rate was 100%. All cases required a degree of manual assistance. No studies had clearly defined patient selection criteria, reference standards, or index tests, preventing meaningful statistical analysis.

CONCLUSIONS: Given the clinical success, it is plausible that robotically performed neurointerventional procedures will eventually benefit patients and reduce occupational hazards for staff; however, there is no high-level efficacy and safety evidence to support this assertion. Limitations of current robotic systems and the challenges that must be overcome to realize the potential for remote teleoperated neurointervention require further investigation.

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