PURPOSE: Robotic endovascular technology may offer advantages over conventional manual catheter techniques. Our aim was to compare the endovascular catheter path-length (PL) for robotic versus manual contralateral gate cannulation during endovascular aneurysm repair (EVAR), using video motion analysis (VMA). METHODS: This was a multicentre retrospective cohort study with fluoroscopic video recordings of 24 EVAR cases (14 robotic, 10 manual) performed by experienced operators (> 50 procedures), obtained from four leading European centres. Groups were comparable with no statistically significant differences in aneurysm size (p = 0.47) or vessel tortuosity (p = 0.68). Two trained assessors used VMA to calculate the catheter PL during contralateral gate cannulation for robotic versus manual approaches. RESULTS: There was a high degree of inter-observer reliability (Cronbach’s α > 0.99) for VMA. Median robotic PL was 35.7 cm [interquartile range, IQR (30.8–51.0)] versus 74.1 cm [IQR (44.3–170.4)] for manual cannulation, p = 0.019. Robotic cases had a median cannulation time of 5.33 min [IQR (4.58–6.49)] versus 1.24 min [IQR (1.13–1.35)] in manual cases (p = 0.0083). Generated efficiency ratios (PL/aorto-iliac centrelines) was 1.6 (1.2–2.1) in robotic cases versus 2.6 (1.7–7.0) in manual, p = 0.031. CONCLUSION: Robot-assisted contralateral gate cannulation in EVAR leads to decreased navigation path lengths and increased economy of movement compared with manual catheter techniques. The benefit could be maximised by prioritising robotic catheter shaping over habituated reliance on guidewire manipulation. Robotic technology has the potential to reduce the endovascular footprint during manipulations even for experienced operators with the added advantage of zero radiation exposure.


    Access

    Download


    Export, share and cite



    Title :

    Comparison of manual versus robot-assisted contralateral gate cannulation in patients undergoing endovascular aneurysm repair


    Contributors:
    Cheung, S (author) / Rahman, R (author) / Bicknell, C (author) / Stoyanov, D (author) / Chang, P-L (author) / Li, M (author) / Rolls, A (author) / Desender, L (author) / Van Herzeele, I (author) / Hamady, M (author)

    Publication date :

    2020-12-01


    Remarks:

    International Journal of Computer Assisted Radiology and Surgery , 15 (12) pp. 2071-2078. (2020)


    Type of media :

    Article (Journal)


    Type of material :

    Electronic Resource


    Language :

    English



    Classification :

    DDC:    629



    Chondroitin-4-Sulfate: A Bioactive Macromolecule to Foster Vascular Healing around Stent-Grafts after Endovascular Aneurysm Repair

    Charbonneau, C. / Gautrot, J. E. / Hebert, M. J. et al. | British Library Online Contents | 2007


    A microrobot for endovascular aneurysm treatment steered and visualized with MPI

    Bakenecker, Anna C. / Von Gladiss, Anselm / Schwenke, Hannes et al. | DataCite | 2022

    Free access

    Autonomous Navigation for Robot-Assisted Intraluminal and Endovascular Procedures: A Systematic Review

    Pore, Ameya / Li, Zhen / Dall'Alba, Diego et al. | BASE | 2023

    Free access


    Chilton's motorcycle repair manual 1981

    Turner, Alan F. | SLUB | 1981