Research Fellow, PhD Candidate Mayo Clinic Rochester Rochester, Minnesota, United States
Introduction: Neuroendovascular interventions using novel technical developments rapidly evolve in neuroradiology and replace open procedures. As a result, they are becoming the first-choice approach for life-threatening neurovascular conditions. The second generation of CorPath GRX's robotic-assisted platform was initially supported and used for peripheral vascular intervention and is currently the only available device for endovascular surgery in the USA. We aimed to discuss the early experience of the robotic system used for endovascular treatment in multiple centers across the USA.
Methods: We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search of electronic databases was conducted using PubMed, Medline, Embase, and Scopus for studies from all available dates. Studies were included only if they reported any information concerning any neurologic intervention (diagnostic or therapeutic) using the CorPath GRX robot along with any subsequent procedural outcomes.
Results: Our literature search yielded 7 studies including a total of 39 patients all of whom underwent robotic endovascular neurologic procedures between 2019 and 2021. This robot was used for three different indications: Symptomatic carotid stenosis (n=20, 51.3%), intracranial aneurysmal procedure (n=13, 33.3%) and cerebral angiography (n=6, 15.4%). Outcomes of all procedures showed that two patients only had residual stenosis 30 days following the intervention and three patients experienced long-term complications (early stasis in an aneurysm remnant and brainstem infarct). No death was reported in any of the cases.
Conclusion : This review demonstrates the feasibility and safety of robotic use for neurovascular interventions including aneurysmal and CAS procedures. Future clinical investigations can potentially assess its usefulness for acute stroke interventions with inherent geographic locations.
