O-046 Robotic diagnostic cerebral angiography: a multicenter experience

Abstract

<h3>Background</h3> Neurointerventional robotic systems may reduce occupational radiation, improve procedural precision, and allow for future remote teleoperation. A limited number of single institution case reports and series have been published outlining the safety and feasibility of robot-assisted diagnostic cerebral angiography. <h3>Methods</h3> This is a multicenter, retrospective case series of patients undergoing diagnostic cerebral angiography at three separate institutions - UC Davis, UCLA, and UCSF - with the assistance of the CorPath GRX Robotic System. <h3>Results</h3> A total of 114 patients underwent robot-assisted diagnostic cerebral angiography from September 28th, 2020 to October 27th, 2022. 113 cases were analyzed given that one case was removed due to insufficient documentation. There were no significant complications related to use of the robotic system including stroke, arterial dissection, bleeding, or pseudoaneurysm formation at the access site. 88 of 113 (77.9%) cases were completed successfully with the robotic system without unplanned manual conversion. Femoral access was conducted in 98 of 113 (86.7%) cases. 14 of 113 (12.4%) cases were conducted using the radial approach (one through a distal snuffbox radial access) and 1 case (0.9%) was conducted with the ulnar approach. Robotic success was achieved in 78 of 98 (79.6%) femoral cases and 10 of 15 (66.6%) radial+ulnar cases. The principal causes for unplanned manual conversion included challenging anatomy, technical difficulty with the bedside robotic cassette, trouble with wire/catheter movement, and hubbing out of the robotic system due to limited working length. For robotic operation, average fluoroscopy time was 13.2 minutes (interquartile range, 9.3 to 16.8 minutes) and average cumulative air kerma was 975.8 mGY (interquartile range, 350.8 to 1073.5 mGy). <h3>Conclusions</h3> Robotic cerebral angiography with the CorPath GRX Robotic System is safe. However, there are significant technical constraints such as working length and device compatibility which may limit its widespread adoption in clinical practice. <h3>Disclosures</h3> <b>C. Beaman:</b> None. <b>A. Gautam:</b> None. <b>C. Peterson:</b> None. <b>N. Kaneko:</b> None. <b>L. Ponce:</b> None. <b>H. Saber:</b> None. <b>K. Khatibi:</b> None. <b>K. Narsinh:</b> None. <b>J. Morales:</b> None. <b>D. Kimball:</b> None. <b>J. Lipovac:</b> None. <b>A. Baker:</b> None. <b>M. Caton:</b> None. <b>E. Smith:</b> None. <b>M. Nour:</b> None. <b>V. Szeder:</b> None. <b>R. Jahan:</b> None. <b>G. Colby:</b> None. <b>B. Cord:</b> None. <b>D. Cooke:</b> None. <b>S. Tateshima:</b> 2; C; Prior consultant for Corindus Vascular Robotics 2018 to 2019. Currently no relationship.. <b>G. Duckwiler:</b> None. <b>B. Waldau:</b> 2; C; Prior consultant for Siemens/Corindus in 2020 but currently has no relationship or stock options with the company.