Randomized trial evaluates a robotic device for guidewire navigation in endovascular procedures, indicating improved safety and autonomy.
Purpose Endovascular therapy is preferred over open surgery due to its minimally invasive nature, faster recovery, and lower perioperative risk; however, fluoroscopy guided procedures are limited by radiation exposure, high equipment costs, and reliance on highly skilled operators. This study aims to develop and evaluate a lightweight, portable robotic system for autonomous guidewire navigation to improve safety, accessibility, and operator independence. Methods A compact 400 g robotic device was designed with millimeter scale positioning accuracy, servo current-based real-time haptic feedback, precise axial rotation, automated retraction advance control, and compatibility with standard endovascular tools. Miniature linear actuated servomotors replicate skilled manual maneuvers using impedance control. Upon tip contact, the system advances the guidewire by 1 mm, measures current changes, classifies lesion stiffness (soft, medium, stiff), and adapts virtual mass-spring-damper gains to regulate push speed and applied force. Bench experiments were conducted using flexible tubing with inserts simulating 20-80% stenosis and two current thresholds (75 and 94 mA). Results Retraction frequency increased with stenosis severity, validating the autonomous control strategy. Lesion stiffness classification achieved F-scores of 0.83, 0.77, and 0.95 for soft, medium, and stiff conditions, respectively, demonstrating reliable discrimination and adaptive force modulation. Conclusions The proposed system enables autonomous and adaptive guidewire advancement with high classification accuracy using low-cost, current-based sensing and impedance control. Its lightweight and portable design reduces dependence on continuous manual operation and specialized imaging infrastructure, supporting safer and faster interventions and potential deployment in prehospital or resource-limited settings. This prototype advances the development of more accessible and operator-independent endovascular therapy.
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Mohammadi et al. (2026) studied this question.
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