Robot and Navigation in the Vascular Tree
Seance of wednesday 30 april 2025 (Ce que le développement des technologies apporte à la sécurité et au soin des patient en chirurgie vasculaire)
DOI number : 10.26299/cpv3-3943/2025.17.04
Abstract
Endovascular robotic navigation and advanced real-time imaging techniques are rapidly expanding fields. They aim to reduce exposure to X-rays, improve operator comfort, and facilitate the catheterization phases.
Endovascular robots:
The Magellan system demonstrated the feasibility and safety of endovascular robotic navigation, but it is no longer commercially available. Currently available devices include the CorPath GRX and Robocath systems. These have undergone preliminary feasibility and safety studies for coronary and neuroradiology procedures but remain sparsely adopted. They allow for precise navigation using low-profile guidewires and catheters. Further studies are needed to evaluate their usefulness in daily practice, particularly in terms of cost-effectiveness.
Advanced real-time imaging techniques:
These innovative techniques allow real-time visualization of endovascular instruments without the use of X-rays. The FORS-Lumiguide system utilizes optical fibers and is mainly used for complex aortic procedures. A randomized study comparing conventional navigation to FORS-guided navigation is about to begin. Electromagnetic tracking of guidewires and catheters (e.g., the IOPS system) has been reported in a few cases. Its combination with augmented reality headsets could represent a further advancement. Ultrasound—particularly intravascular ultrasound (IVUS)—is also used in targeted indications to assist the operator during endovascular tasks.
In summary, although endovascular robots and vascular navigation systems represent a significant technological advancement, their widespread adoption will depend on their ability to demonstrate clear clinical benefits and to overcome economic and technical challenges.
Endovascular robots:
The Magellan system demonstrated the feasibility and safety of endovascular robotic navigation, but it is no longer commercially available. Currently available devices include the CorPath GRX and Robocath systems. These have undergone preliminary feasibility and safety studies for coronary and neuroradiology procedures but remain sparsely adopted. They allow for precise navigation using low-profile guidewires and catheters. Further studies are needed to evaluate their usefulness in daily practice, particularly in terms of cost-effectiveness.
Advanced real-time imaging techniques:
These innovative techniques allow real-time visualization of endovascular instruments without the use of X-rays. The FORS-Lumiguide system utilizes optical fibers and is mainly used for complex aortic procedures. A randomized study comparing conventional navigation to FORS-guided navigation is about to begin. Electromagnetic tracking of guidewires and catheters (e.g., the IOPS system) has been reported in a few cases. Its combination with augmented reality headsets could represent a further advancement. Ultrasound—particularly intravascular ultrasound (IVUS)—is also used in targeted indications to assist the operator during endovascular tasks.
In summary, although endovascular robots and vascular navigation systems represent a significant technological advancement, their widespread adoption will depend on their ability to demonstrate clear clinical benefits and to overcome economic and technical challenges.