New assistive technologies supporting high-risk interventional procedures are being developed by an interdisciplinary team of surgeons and engineers at Vanderbilt University Medical Center. While prototypes center around neurointervention and stroke prevention, the work could apply across endovascular procedures.
“There are two things that we hope to do. One is to make the catheters ‘smart’ so that they can steer themselves, or at least help steer. The second goal is to create a path that the catheter can follow autonomously in a safe way,” said Rohan Chitale, M.D., an associate professor of neurological surgery at Vanderbilt.
Chitale is leading the efforts in close partnership with Nabil Simaan, Ph.D., a professor of mechanical engineering, computer science and otolaryngology at Vanderbilt. The work falls within the Vanderbilt Institute for Surgery and Engineering (VISE).
Self-navigating catheters could improve the ability to move through complex twists and bends in blood vessels during procedures such as thrombectomies in the brain. Interventionalists can robotically bend the tips of the “smart” catheters to enhance steering capabilities.
“Our system promises to help surgeons who don’t regularly go up into these blood vessels.”
“The prototype catheter right now is made of nitinol,” Chitale explained. “It has the characteristics and flexibility of a normal catheter, and we can deploy different devices that we already use through it.”
He adds that the robotic portion, or actuator, connects to the existing angiography table and is controlled by a joystick.
Reduced Technical Burden
The technology could make thrombectomy for acute stroke treatment much more available by reducing the technical burden of the procedure, Chitale says.
“With large vessel occlusions, quick removal can make a great difference in terms of keeping the patient from becoming severely disabled or debilitated,” he said. “Our system promises to help surgeons who don’t regularly go up into these blood vessels.”
“Our goal is to develop technologies that clarify, simplify and speed up the process of removing a clot. Time is brain.”
Additionally, such a system might allow training or novice interventionalists to perform procedures more safely. Future iterations might even support remote proctoring, enabling a Vanderbilt neurosurgeon, for example, to operate on a patient in a more rural area, Chitale explained. This research is in its early stages; the investigators are currently working with in vitro phantom vascular models.
A Golden Age for Stroke Treatment
The work is part of a larger movement to incorporate AI and robotics into precision interventions. Additional work through VISE and others at Vanderbilt is bringing such technology to everything from urologic surgery to delivery of ocular therapeutics.
Chitale has always been interested in the anatomy of the brain. He appreciates that his research tests the limits of his abilities and places him at the frontiers of what some call a “golden age” of acute stroke treatment.
“Our goal is to develop technologies that clarify, simplify and speed up the process of removing a clot. Time is brain,” he said.