Intravascular Robotics: Ready for Prime Time

Over the past 2 decades, a paradigm shift has occurred in the treatment of vascular disease, with dramatic growth in the use of endovascular techniques. Today, approximately two-thirds of abdominal aortic aneurysm repairs are performed via the endovascular approach, and catheterbased techniques are rapidly growing for the treatment of lower extremity peripheral artery disease. These trends have been driven by patient demand for procedures that are less invasive and involve fewer complications and faster recovery, but it is also aided by rapid and continuous innovation in endovascular access and therapeutic devices. Despite this growth and innovation, limitations remain in terms of what can be achieved via an endovascular approach. Using traditional guidewire and catheter technologies, physicians are, at times, unable to reach, cross, or effectively treat a patient’s disease. Vascular tortuosity, lesion morphology and location, and operator technique can all contribute to variability in procedural outcomes. The result is that many patients who might benefit from a minimally invasive, endovascular procedure must undergo open surgery or may not receive treatment at all. In addition, image-guided procedures expose interventionists to significant occupational hazards, including the cumulative and permanent effects of long-term exposure to low-dose, ionizing radiation and musculoskeletal hazards stemming from use of personal protection equipment, such as lead aprons, etc.