Robotic Devices for Minimally Invasive Endovascular Interventions: A New Dawn for Interventional Radiology

Abstract

Minimally invasive endovascular interventions have become the cornerstone of medical practice in the treatment of a variety of vascular diseases. Tools developed for these interventions have also opened new avenues for targeted delivery of therapeutics, such as chemotherapy or radiation therapy, using the vessels as highways into remote lesions. A more ambitious move toward an all‐endovascular approach to acute or chronic conditions, however, is fundamentally hindered by a variety of challenges, such as the complexity of the vascular anatomy, access to smaller vessels, the fragility of diseased vessels, emergency procedure requirements, prolonged exposure to ionizing X‐ray radiation, and patient‐specific factors including coagulopathy. These shortcomings necessitate new advances to the current practice. Smart soft‐body robots that fit the smallest vessels with high‐precision wireless control and autonomous capabilities have the potential to set the future standards of minimally invasive endovascular therapies. Herein, the current state of the small‐scale robotics from the viewpoint of endovascular applications is discussed, and their potential advantages to the existing tethered clinical devices are compared. Then, technical challenges and the clinical requirements toward realistic applications of small‐scale untethered robots inside the vasculature are discussed.