Endovascular intervention is a procedure performed in emergency situations to treat strokes caused by a blood clot. Such interventions normally require a surgeon to manually guide a thin wire to the clot, where it can physically clear the blockage or deliver drugs to break it up. One limitation of such procedures is accessibility: Neurovascular surgeons are often based at major medical institutions that are difficult to reach for patients in remote areas, particularly during the “golden hour” - the critical period after a stroke’s onset, during which treatment should be administered to minimize any damage to the brain. Now, engineers have developed a telerobotic system whose movement is controlled through magnets and is designed to remotely assist in endovascular intervention.

The robotic system has been developed by engineers at the Massachusetts Institute of Technology (MIT, Boston, MA, USA) to help surgeons quickly and remotely treat patients experiencing a stroke or aneurysm. With a modified joystick, surgeons in one hospital may control a robotic arm at another location to safely operate on a patient during a critical window of time that could save the patient’s life and preserve their brain function. The MIT team envisions that its robotic system could be installed at smaller hospitals and remotely guided by trained surgeons at larger medical centers. The system includes a medical-grade robotic arm with a magnet attached to its wrist. With a joystick and live imaging, an operator can adjust the magnet’s orientation and manipulate the arm to guide a soft and thin magnetic wire through arteries and vessels.

The researchers demonstrated the system in a “phantom,” a transparent model with vessels replicating complex arteries of the brain. With just an hour of training, neurosurgeons were able to remotely control the robot’s arm to guide a wire through a maze of vessels to reach target locations in the model. The researchers hope that the teleoperated system can help more patients receive time-critical treatment. The team also sees benefits for surgeons, who typically perform such vascular procedures in the same room as the patient, while being exposed to radiation from X-ray imaging.

“We imagine, instead of transporting a patient from a rural area to a large city, they could go to a local hospital where nurses could set up this system. A neurosurgeon at a major medical center could watch live imaging of the patient and use the robot to operate in that golden hour. That’s our future dream,” said Xuanhe Zhao, a professor of mechanical engineering and of civil and environmental engineering at MIT.

“The neurosurgeons can operate the robot in another room or even in another city without repeated exposure to X-rays,” added Zhao. “We are truly excited about the potential impact of this technology on global health, given that stroke is one of the leading causes of death and long-term disability.”

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