Doctors treat brain aneurysm using robotics

Doctors successfully used robotic technology to treat brain aneurysms. Ultimately the robotic system could allow remote surgery, allowing surgeons to treat distant brain disorders that require surgery.

The use of a robot to treat brain aneurysms is feasible and could improve the accuracy of stents, coils, and other devices, according to late-breaking science presented today at the American Stroke Association's International Stroke Conference 19-21 February 2020. The conference in Los Angeles is a world premiere meeting for the researchers and clinicians dedicated to stroke science and brain health.

Robotic technology is used in the surgery and cardiology but not for vascular procedures in the brain. Canadian researchers in this study report the results of the first robotic brain vascular procedures. They used a robotic system specially adapted to neurovascular procedures. Software and hardware modifications make it possible to handle microcatheters, guide wires and other instruments used in endovascular brain procedures. Such improvements also provide the user with more precise fine-motor control compared to the previous machine versions.

According to lead researcher Vitor Mendes Pereira, M.D., M.Sc., neurosurgeon and neuroradiologist at Toronto Western Hospital, and professor of medical imaging and surgery at the University of Toronto, Canada, “this study is the first step towards our dream of remote neurovascular procedures. The ability to robotically perform intracranial aneurysm treatment is a significant step forward in the neuro-endovascular intervention.”

In the first instance, a 64-year-old female patient had an unbroken aneurysm at the base of her skull. The surgical team successfully used the robot to place a stent and then, using the same microcatheter, entered the aneurysm bag and secured the aneurysm by inserting several coils. All intracranial steps have been performed with a robotic arm. Since this first case the team has completed five additional robotic aneurysm treatments which include the deployment of various devices such as flow-diversity stents.

Mendes Pereira said, “the expectation is that potential robotic systems will be able to be remotely operated. For instance, I could be in my hospital and provide therapy to a patient hundreds or even thousands of miles away. The ability to deliver rapid care through remote robotics for time-critical procedures such as stroke could have a huge impact on the improving patient outcomes and allow us to deliver cutting-edge care to patients everywhere, regardless of geography.”

Mendes Pereira added,  "our experience and that of future operators of this technology will help to develop the workflows and processes needed to implement successful robotic programs that will ultimately help to establish remote care networks in the future.”

The list of authors of the study and the reports are included in the abstract. The work reported was financed from the institutional sources. Corindus, the Siemens Healthineers Company, provided single-use cassettes.