Robot-Assisted Brain Angiography Improves Procedural Outcomes

Digital subtraction angiography remains the gold standard for diagnosing cerebrovascular conditions such as intracranial aneurysms, arteriovenous malformations, and arterial stenosis. However, the procedure requires physicians to operate under continuous fluoroscopic imaging, exposing them to ionizing radiation over extended periods. Now, a robot-assisted system that allows clinicians to perform cerebral angiography remotely can potentially reduce operator radiation exposure while maintaining procedural accuracy.

Researchers from Peking Union Medical College Hospital (PUMCH, Beijing, China) conducted a clinical study to evaluate the clinical safety and performance of a domestically developed robot-assisted vascular intervention system, YDHB-NS01, which is designed to assist physicians during diagnostic cerebral angiography procedures. The prospective study enrolled 50 patients between May and August 2025 at a single center. Twenty-five patients underwent robot-assisted cerebral angiography while another 25 underwent conventional manual procedures. All procedures were performed by the same neurosurgeon to ensure consistency in technique.

Both the robotic-assisted and manual groups achieved a 100 percent technical and clinical success rate. In every case, the target vessels were clearly visualized and met the diagnostic requirements of the procedure. The robotic-assisted group demonstrated a shorter median procedure time of 27 minutes compared with 38 minutes in the manual group. Other parameters, including fluoroscopy time, patient radiation dose, contrast agent usage, and total angiography room time, showed no statistically significant differences between the two groups.

The YDHB-NS01 robotic system functioned reliably throughout the procedures without mechanical failures or system interruptions. Operators reported stable catheter and guidewire navigation, responsive control handles, and effective manipulator stability. Importantly, no complications were observed among the 50 patients included in the study. There were no puncture-related events, vascular injuries, thromboembolic complications, or neurological issues such as transient ischemic attacks or ischemic stroke. Additionally, no contrast-related adverse reactions were reported.

The researchers also observed a learning curve during early robotic-assisted cases. The first two procedures required longer procedural times and higher radiation exposure, while the remaining cases showed improved consistency as operators gained experience with the system. Robot-assisted systems are increasingly being explored in neurovascular interventions to improve procedural precision and reduce occupational radiation exposure for clinicians.

The study, published in Chinese Neurosurgical Journal, also reviewed the broader development of robotic technologies used in cerebrovascular procedures, including their reported outcomes and limitations. While the initial results demonstrate feasibility and safety, the researchers emphasize that larger multicenter studies will be necessary to confirm the system’s effectiveness and evaluate its broader clinical impact.

“The preliminary clinical application demonstrates that the YDHB-NS01 robot-assisted system is feasible for diagnostic cerebral angiography and shows early indications of safety and comparable procedural performance to those of conventional manual methods,” said PUMCH’s Dr. Yuanli Zhao, who led the research team.

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