Remote Teleoperation of Endovascular Intervention Robots: A Systematic Review

Abstract

Remote robotic-assisted endovascular intervention offers a promising approach to reduce clinician radiation exposure and physical strain, while extending specialized vascular care to geographically distant regions. Despite advancements, teleoperated endovascular intervention remains underexplored, especially for time-sensitive interventions like mechanical thrombectomy for acute stroke. The aim of the current review was to determine the evidence regarding teleoperated endovascular robotic systems, covering technical feasibility, communication infrastructure, and clinical outcomes. The review further identified research gaps and future directions. Following PRISMA guidelines, 16 studies were included that met the inclusion criteria out of 2501 initial search results. We found that teleoperated catheters and guidewires, driven by mechanical or electromagnetic systems, can be navigated across distances up to 7000 km. With robust communication infrastructure, network latency remained within clinically acceptable limits (30-163 ms). Although initial outcomes highlighted 100% procedural success in small-scale human trials, most evidence stemmed from animal or phantom models. Overall, the findings suggest that teleoperated endovascular intervention can reduce occupational hazards, expand patient access to urgent procedures, and optimize resource allocation. Future research should be conducted in low and middle income countries to demonstrate broader geographical access. Ultimately, multi-center clinical trials are required to validate the safety, efficacy, and generalization in diverse clinical settings.