Force Measurement in Robot-Assisted Endovascular Procedures: A Systematic Review

Abstract

Use of endovascular therapy continues to expand due to its effectiveness and minimally invasive characteristics, prompting growing interest in teleoperated robotic systems that can extend access in rural settings and improve physicians well-being. These robotic platforms support physicians in the precise manipulation of endovascular devices, yet the importance for providing haptic feedback within such systems remains a topic of debate. Although several recent works outline techniques for delivering force cues to physicians, comparatively little attention has been given to how these forces are sensed on the robotic side. To clarify this aspect, this study reports a systematic literature review conducted under PRISMA guidelines, supplemented with a bias assessment to ensure cross-database consistency. From an initial pool of 641 publications, eight principal categories of endovascular forces were identified, with reported values spanning $0.17~{\mathrm {N }}$ to $2.61~{\mathrm {N }}$ and occasional peaks reaching $25~{\mathrm {N }}$ . Most measurements were obtained through sensors integrated either on the robotic drive mechanisms or directly onto endovascular devices. In addition, the review highlights emerging directions, including human limits on force sensing, hybrid sensing–estimation methods and the need for force characterization in therapeutic devices. Addressing these aspects will be essential to support future force feedback strategies and improve force assessments in both robot-assisted and manual endovascular procedures.