IEEE Trans Biomed Eng. 2021 Oct;68(10):3110-3121. doi: 10.1109/TBME.2021.3065146. Epub 2021 Sep 20.
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.
心血管疾病是全球死亡的最常见原因。血管内介入治疗与先进的成像技术相结合，是微创诊断和治疗的有前途的方法。最近，远程操作机器人平台旨在提高操作精度、稳定血管内器械以及减少患者康复时间。然而，最近的平台的优势因缺乏触觉反馈和患者仍会暴露在电离辐射下而受到削弱。本研究旨在设计、实现和评估一种新型的血管内机器人平台，该平台可适应新兴的非电离磁共振成像（MRI）技术。
我们提出了一种气动驱动的磁共振安全远程操作平台，用于远程操作血管内器械，并为操作人员提供血管内任务的触觉反馈。该平台的任务性能在一项离体插管研究中进行了评估，该研究由临床专家（N=7）在透视引导和腹部及胸部体模上的触觉辅助下进行。
研究表明，涉及气动致动概念的机器人灵巧性能够成功地远程插管不同的血管解剖结构，成功率为 90%-100%。与手动插管相比，在特定任务中，器械与体模之间的交互力略低。最大机器人交互力不超过 3N。
这项研究展示了一种有前途的多功能机器人技术，可用于磁共振环境下的血管内器械远程操作。
该结果为使用非电离实时 3D MR 引导的血管内介入治疗部署设备铺平了道路。
