An MR-Safe Endovascular Robotic Platform: Design, Control, and Ex-Vivo Evaluation.

Abstract

Cardiovascular diseases are the most common cause of global death. Endovascular interventions, in combination with advanced imaging technologies, are promising approaches for minimally invasive diagnosis and therapy. More recently, teleoperated robotic platforms target improved manipulation accuracy, stabilisation of instruments in the vasculature, and reduction of patient recovery times. However, benefits of recent platforms are undermined by a lack of haptics and residual patient exposure to ionising radiation. The purpose of this research was to design, implement, and evaluate a novel endovascular robotic platform, which accommodates emerging non-ionising magnetic resonance imaging (MRI). We proposed a pneumatically actuated MR-safe teleoperation platform to manipulate endovascular instrumentation remotely and to provide operators with haptic feedback for endovascular tasks. The platform task performance was evaluated in an ex vivo cannulation study with clinical experts ( N = 7) under fluoroscopic guidance and haptic assistance on abdominal and thoracic phantoms. The study demonstrated that the robotic dexterity involving pneumatic actuation concepts enabled successful remote cannulation of different vascular anatomies with success rates of 90%-100%. Compared to manual cannulation, slightly lower interaction forces between instrumentation and phantoms were measured for specific tasks. The maximum robotic interaction forces did not exceed 3N. This research demonstrates a promising versatile robotic technology for remote manipulation of endovascular instrumentation in MR environments. The results pave the way for clinical translation with device deployment to endovascular interventions using non-ionising real-time 3D MR guidance.