Robotic assisted carotid artery stenting for the treatment of symptomatic carotid disease: technical feasibility and preliminary results

Nogueira, Raul G; Sachdeva, Rajesh; Al‐Bayati, Alhamza R; Mohammaden, Mahmoud; Frankel, Michael; Haussen, Diogo C

doi:10.1136/neurintsurg-2019-015754

Cited by 52 publications

(48 citation statements)

References 11 publications

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“…Closely related to this topic is the introduction of robotics into the neurointerventional routine. To date, few groups have reported small case series of successful robot-assisted elective procedures [31][32][33], and first attempts are being made to create ethical and medicolegal frameworks [34] for neurointerventional robotics. The degree of autonomy of current robotic systems is however very low and their utility restricted by the incapability of performing essential tasks, such as puncturing the groin.…”

Section: Desirable Developments We Should Aim For In the Near Futurementioning

confidence: 99%

Neurointervention in the 2020s: Where are We Going?

Goyal

Zwam

Moret³

et al. 2020

Clin Neuroradiol

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The 1970s and 1980s-Discovery The history of neurointervention is short as our field is still in its puberty. If one had to pinpoint a starting date, most would agree it was the early 1970s, although Luessenhop and Spence described a case of an endovascular embolization of a brain arteriovenous malformation as early as 1960 [1]. The 1970s was the time when the pioneers of the field boldly went where no one had gone before. Their brilliant minds made huge advancements in the understanding of complex vessel anatomy and neurovascular pathology, and we have to particularly recognize the tremendous input of Pierre Lasjaunias in the delicate and precise description of the vascular microanatomy of the base of the skull, and Fedor Serbinenko, who developed a technique to treat intracranial aneurysms and carotid cavernous sinus fistulas with a detachable latex balloon [2]. In the 1980s, Zeumer and Theron entered the field of endovascular stroke treatment and opened intracranial occlusions with locally administered fibrinolytics [3, 4]. Only a few conditions were treatable but the sudden knowledge gain was massive and

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Section: Desirable Developments We Should Aim For In the Near Futurementioning

confidence: 99%

Neurointervention in the 2020s: Where are We Going?

Goyal

Zwam

Moret³

et al. 2020

Clin Neuroradiol

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“…Furthermore, transradial carotid artery stenting has demonstrated feasibility and safety in CAS[ 30 - 32 ]. Recently, robotic-assisted CAS has been shown to be technically feasible; however, further studies are warranted to properly establish the safety and benefits of this technique[ 30 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Ileal hemorrhagic infarction after carotid artery stenting: A case report and review of the literature

Shen

et al. 2021

WJCC

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BACKGROUND Ileal hemorrhagic infarction after carotid artery stenting (CAS) is a fatal complication. The prognosis of ileal hemorrhagic infarction after CAS is very poor if not treated in a timely manner. We describe a rare case of ileal hemorrhagic infarction due to acute embolism of the mesenteric artery after CAS. CASE SUMMARY A 67-year-old man with acute ischemic stroke underwent CAS via the right femoral artery approach 21 d after intensive medical treatment. On the first day after surgery, the patient had abdominal distension and abdominal pain. Abdominal enhanced computed tomography revealed intestinal obstruction, severe stenosis of the superior mesenteric artery, and poor distal angiography. An exploratory laparotomy was performed, and pathological examination showed hemorrhagic ileal infarction. It was subsequently found that the patient had intestinal flatulence. With the guidance of an ultrasound scan, the patient underwent abdominal puncture, drainage, and catheterization. After 58 d of treatment, the patient was discharged from hospital with a National Institutes of Health Stroke Scale score of 2 points, and a Modified Rankin Scale score of 1 point. At the 6-mo follow-up, the patient had an excellent functional outcome without stroke or mesenteric ischemia. Furthermore, computed tomography angiography showed that the carotid stent was patent. CONCLUSION Ileal hemorrhagic infarction is a fatal complication after CAS, usually caused by mesenteric artery embolism. Thus, more attention should be paid to the complications of embolism in the vascular system as well as the nervous system after CAS, and the complications should be identified and treated as early as possible.

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“…A similar research group conducted a retrospective comparison of transradial robot-assisted carotid stent placement with manual stent placement and found that the mean procedural duration was significantly longer while using the robot (85.0 [SD, 14.3] versus 61.2 [SD, 17.5] minutes), but there was no significant difference in other procedural characteristics such as fluoroscopy time, contrast dose, radiation exposure, catheter exchanges, technical success, transfemoral conversion, and complications. 54 Nogueira et al 55 also recently treated 4 patients with severe symptomatic carotid stenosis and achieved technical and procedural success. All steps of the procedure were completed by the robotic system except for navigation and deployment of the stent, which is currently incompatible.…”

Section: Clinical Applications Of Robotic Neurointerventionmentioning

confidence: 99%

A Review of Robotic Interventional Neuroradiology

Beaman

Kaneko

Meyers

et al. 2021

AJNR Am J Neuroradiol

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Robotic interventional neuroradiology is an emerging field with the potential to enhance patient safety, reduce occupational hazards, and expand systems of care. Endovascular robots allow the operator to precisely control guidewires and catheters from a lead-shielded cockpit located several feet (or potentially hundreds of miles) from the patient. This has opened up the possibility of expanding telestroke networks to patients without access to life-saving procedures such as stroke thrombectomy and cerebral aneurysm occlusion by highly-experienced physicians. The prototype machines, first developed in the early 2000s, have evolved into machines capable of a broad range of techniques, while incorporating newly automated maneuvers and safety algorithms. In recent years, preliminary clinical research has been published demonstrating the safety and feasibility of the technology in cerebral angiography and intracranial intervention. The next step is to conduct larger, multisite, prospective studies to assess generalizability and, ultimately, improve patient outcomes in neurovascular disease.

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Robotic assisted carotid artery stenting for the treatment of symptomatic carotid disease: technical feasibility and preliminary results

Cited by 52 publications

References 11 publications

Neurointervention in the 2020s: Where are We Going?

Neurointervention in the 2020s: Where are We Going?

Ileal hemorrhagic infarction after carotid artery stenting: A case report and review of the literature

A Review of Robotic Interventional Neuroradiology

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