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Case Reports
. 2020 Apr;12(4):341-344.
doi: 10.1136/neurintsurg-2019-015754. Epub 2020 Mar 1.

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

Raul G Nogueira  1   2 , Rajesh Sachdeva  2   3 , Alhamza R Al-Bayati  4   2 , Mahmoud H Mohammaden  4   2 , Michael R Frankel  4   2 , Diogo C Haussen  4   2
Affiliations
Case Reports

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

Raul G Nogueira et al. J Neurointerv Surg. 2020 Apr.

Abstract

Background and purpose: Robotic-assisted endovascular interventions have been increasingly performed in the coronary and peripheral vascular beds. We aim to describe the feasibility and initial safety of a robotic-assisted platform for treating carotid artery disease.

Methods: Single-center technical report of the first four consecutive cases of carotid artery stenting for the treatment of severe symptomatic carotid stenosis utilizing the CorPath GRX Robotic System (Corindus Inc, Waltham, MA).

Results: Four patients (one in early 60s and three in early 70s; NASCET degree of stenosis: 88%, 77%, 83% and 82%) with ipsilateral strokes on presentation were treated. All steps of the procedure (including delivery/removal of micro-guidewire, emboli-protection system and angioplasty balloon) could be successfully performed robotically with the exception of navigation/deployment of the stents due to incompatibility with the current robotic platform. Technical success was achieved in all patients resulting in resolution of the stenosis without any complications.

Conclusions: Robotic-assisted carotid artery stenting is technically feasible. Future studies are warranted to properly establish safety and benefits.

Keywords: stenosis; stent; stroke; technique.

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Conflict of interest statement

Competing interests: RGN: Corindus Vascular Robotics (Physician Advisory Board, stock options). Unrelated to this research: RGN: Stryker Neurovascular (DAWN Trial Principal Investigator- no compensation, TREVO Registry Steering Committee – no compensation, Trevo-2 Trial Principal Investigator- modest; Consultant - significant); Medtronic (SWIFT Trial Steering Committee - modest; SWIFT-Prime Trial Steering Committee – no compensation; STAR Trial Angiographic Core Lab - significant); Penumbra (3D Separator Trial Executive Committee – no compensation); Cerenovus/ Neuravi (ENDOLOW Trial Principal Investigator, EXCELLENT Registry Principal Investigator, ARISE-2 trial Steering Committee – no compensation, Physician Advisory Board, modest); Phenox (PROST Trial Principal Investigator, Physician Advisory Board, modest); Anaconda (Physician Advisory Board, modest); Genentech (Physician Advisory Board – modest); Biogen (CHARM Trial Steering Committee; Physician Advisory Board – modest); Prolong Pharmaceuticals (Physician Advisory Board – modest); Allm Inc. (Physician Advisory Board – no compensation); IschemaView (Speaker, modest); Brainomix (Physician Advisory Board, stock options); Sensome (Research Device Use – no compensation); Viz-AI (Physician Advisory Board, stock options); Philips (Research Software Use – no compensation, Speaker - modest); Vesalio (Physician Advisory Board, stock options); Ceretrieve (Physician Advisory Board, stock options); Astrocyte (Physician Advisory Board, stock options). DCH: Consultant for Stryker and Vesalio, Viz-AI (stock options).

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