P149/163  A comparative in vitro study of manual and robot-assisted mechanical thrombectomy

Abstract

<h3>Introduction</h3> Robot-assisted endovascular treatment (EVT) of stroke is a promising alternative to allow immediate treatment in patients located away from comprehensive stroke centers. <h3>Aim of Study</h3> We aimed to explore the feasibility and efficacy of robot-assisted EVT. <h3>Methods</h3> Clot analogs were used to create middle cerebral artery (M1-MCA) occlusions in a benchtop 3D printed model. After occlusion, experiments were allocated to be treated manually by a peripheral interventionalist with basic EVT training (Manual-EVT) or with the Corindus Corepath robot by an expert neurointerventionalist (Robotic-EVT). Thrombectomy technique consisted of retrieving the SR into a balloon guide catheter under proximal flow arrest and continuous aspiration. First pass recanalization (FPR= TICI 2c-3) was assessed, and distal emboli were collected and analyzed after each experiment. <h3>Results</h3> Overall, 45 experiments were performed with Robotic-EVT (n=24) or Manual-EVT (n=21). Rate of complete recanalization tended to be higher with Robotic-EVT (95.8%) than with Manual-EVT (71.4%; p=0.06). The mean count of collected emboli in the distal filter was similar: Robotic-EVT: 19.67±17 Vs Manual-EVT: 16.67±13 (p=0.59). The mean duration per pass was longer with Robotic-EVT (6.8±1.5 minutes) than with Manual-EVT (3.8±1.6 minutes; p&lt;0.01). <h3>Conclusion</h3> In experimental bench conditions, robot-assisted EVT performed by experienced neurointerventionalists is feasible and highly effective without inducing substantial procedural delays. <h3>Disclosure of Interest</h3> MR received research funding from Medtronic and <h3>Vesalio</h3> MR declares ownership of Anaconda Biomed and Methinks shares. MR received consulting fees from Anaconda Biomed, Apta Targets, Medtronic, Stryker, Cerenovus, and Philips. AT reports receiving consulting fees from Anaconda Biomed, Balt, Medtronic, MicroVention, Cerus, Merlin Medical, and Stryker.