Bridging the gap: robotic applications in cerebral aneurysms neurointerventions - a systematic review.

Cerebral aneurysm is a life-threatening condition, which requires high precision during the neurosurgical procedures. Increasing progress of evaluating modern devices in medicine have led to common usage of robotic systems in many fields, including cranial aneurysm operations. However, currently no systematic review describes up-to date knowledge of this topic. Following PRISMA guidelines, we have independently screened and extracted works from seven databases. Only studies fulfilling inclusion criteria were presented in this study. Device used, operation time, complications, aneurysm type and patient demographics were extracted from each work. We identified a total of 995 articles from databases. We have found six original works and one supplementary article eligible for this synthesis. Majority of works (4/6) have implemented CorPath GRX in cerebral aneurysm procedures. The procedures involved diverse aneurysm locations, utilizing flow diverters, stents, or coiling. One study described implementation of robot-assist on 117 patients and compared results to randomized clinical trials. One work with a small patient cohort described use of the magnetically-controlled microguidewire in the coiling procedures, without any complications. Additionally, one case-series study described use of a robotic arm for managing intraoperative aneurysm rupture. Currently, robotical devices for cerebral aneurysm treatment mainly lack jailing and haptic feedback feature. Further development of these devices will certainly be beneficial for operators and patients, allowing for more precise and remote surgeries.

Machine Meets Brain: A Systematic Review of Effectiveness of Robotically Performed Cerebral Angiography Interventions.

BACKGROUND: Stroke is a leading cause of death in the United States, with significant economic and human costs. Early diagnosis and rapid treatment are critical for preventing stroke-related morbidity and mortality. However, accessibility to neurointerventional medical centers remains a challenge for many Americans, highlighting the need for innovative solutions to improve stroke management. METHODS: This systematic review adhered to the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines and included 5 medical databases to identify relevant studies on robotically assisted cerebral angiography (RCA). Studies focusing on in-human robotic intracranial cerebral angiography were included. A bias assessment was conducted using appropriate tools for randomized controlled trials (RCTs) and non-RCTs. RESULTS: A total of 7 studies met the inclusion criteria, with 1 RCT and 6 non-RCTs included in the analysis. Robotic systems such as CorPath GRX, Magellan robot, YDHB-NS01, VIR-2 (vascular interventional robot), and RobEnt were evaluated. The studies reported various success rates, procedure times, and complications associated with robotically assisted procedures. Overall, the robotic interventions demonstrated promising results in terms of safety and efficacy, with comparable outcomes to manual methods. Despite the promising findings, several limitations were identified, including technical issues with the robotic systems, the high costs, and limited long-term data. Future research should focus on standardizing protocols, conducting larger trials with longer follow-up periods, and assessing cost-effectiveness to determine the role of RCA in clinical practice. CONCLUSIONS: RCA shows potential as a valuable tool in neuroendovascular interventions. Addressing the technical challenges and conducting further research will be crucial to fully realize the clinical benefits of this innovative technology and improve patient outcomes in stroke management.