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机器人辅助血流导向装置置入术治疗颅内和颈部动脉瘤。

Robotically assisted deployment of flow diverter stents for the treatment of cerebral and cervical aneurysms.

机构信息

Department of Radiology, Amiens University Hospital, Amiens, Hauts-de-France, France

Image Processing Department, Amiens University Hospital, Amiens, Hauts de France, France.

出版信息

J Neurointerv Surg. 2024 Mar 14;16(4):412-417. doi: 10.1136/jnis-2022-019968.

DOI:10.1136/jnis-2022-019968
PMID:37001986
Abstract

BACKGROUND

Despite the growing sophistication of robot-assisted surgery, it is necessary to demonstrate that robots can reliably perform complex procedures on site and then remotely. Although a flow diverter stent is one of the most effective and widely used devices, its placement is sometimes challenging.

OBJECTIVE

To evaluate the feasibility and safety of the CorPath GRX robotic platform for the embolization of cerebral and cervical aneurysms using flow diverter stents.

METHODS

We performed a single-center technical study of the first 10 flow diverter stent deployments with the CorPath GRX Robotic System (Corindus Inc, Waltham, Massachusetts, USA) for the treatment of cerebral aneurysms between April and October 2022.

RESULTS

Ten patients underwent robot-assisted embolization with flow diverter stents: there were nine intracranial aneurysms (paraclinoid n=6; posterior communicating artery aneurysm n=1; anterior communicating artery n=2) and one cervical aneurysm. Four procedures were performed with coils plus a flow diverter stent, one was performed with woven endobridge plus a flow diverter stent and four were performed with flow diverter stents alone. Of these procedures, two were performed with telescoping flow diverters.All flow diverter stents were deployed with robotic assistance, with only one partial conversion to a manual technique (caused by guidewire torquability limitations). No perioperative complications were observed.

CONCLUSION

Robot-assisted flow diverter stent deployment using the CorPath GRX platform is feasible and appears to be safe. Larger, in-depth studies of the technique's safety and benefits are now warranted.

摘要

背景

尽管机器人辅助手术技术日益成熟,但仍有必要证明机器人能够可靠地在现场和远程执行复杂的手术。尽管血流导向装置是最有效和广泛使用的装置之一,但有时其放置仍具有挑战性。

目的

评估 CorPath GRX 机器人平台在使用血流导向装置栓塞脑和颈动脉瘤中的可行性和安全性。

方法

我们对 2022 年 4 月至 10 月期间使用 CorPath GRX 机器人系统(美国马萨诸塞州沃尔瑟姆的 Corindus Inc.)进行的首例 10 例血流导向装置栓塞术进行了单中心技术研究。

结果

10 例患者接受了机器人辅助血流导向装置栓塞术:其中 9 例为颅内动脉瘤(颈内动脉床突旁段动脉瘤 6 例;后交通动脉瘤 1 例;前交通动脉瘤 2 例),1 例为颈动脉瘤。4 例手术采用线圈加血流导向装置,1 例采用编织型 EndoBridge 加血流导向装置,4 例单独采用血流导向装置。其中 2 例采用可伸缩血流导向器。所有血流导向装置均在机器人辅助下进行了部署,仅 1 例因导丝扭矩限制而部分转为手动技术。无围手术期并发症发生。

结论

使用 CorPath GRX 平台进行机器人辅助血流导向装置支架置入术是可行的,并且似乎是安全的。现在需要更大规模、更深入的研究来评估该技术的安全性和益处。

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J Neurointerv Surg. 2024 Mar 14;16(4):412-417. doi: 10.1136/jnis-2022-019968.
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