Toward a Versatile Robotic Platform for Fluoroscopy and MRIGuided Endovascular Interventions: A PreClinical Study Cardiovascular diseases remain as the most common cause of death worldwide. Remotely manipulated robotic systems are utilized to perform minimally invasive endovascular interventions. The main benefits of this methodology include reduced recovery time, improvement of clinical skills and procedural facilitation. Currently, robotic assistance, precision, and stability of instrument manipulation are compensated by the lack of haptic feedback and an excessive amount of radiation to the patient. This paper proposes a novel masterslave robotic platform that aims to bring the haptic feedback benefit on the master side, providing an intuitive user interface, and clinical familiar workflow. The slave robot is capable of manipulating conventional catheters and guidewires in multimodal imaging environments. The system has been initially tested in a phantom cannulation study under fluoroscopic guidance, evaluating its reliability and procedural protocol. As the slave robot has been entirely produced by additive manufacturing and using pneumatic actuation, MR compatibility is enabled and was evaluated in a preliminary study. Results of both studies strongly support the applicability of the robot in different imaging environments and prospective clinical translation.

Haptic Guidance for RobotAssisted Endovascular Procedures: Implementation and Evaluation on Surgical Simulator Vascular diseases are the most common precursors to ischemic heart disease and stroke, which are two of the leading causes of death worldwide. Endovascular intervention is a minimally invasive surgical approach to treat such diseases. Compared to open surgery, it has the advantages of faster recovery, reduced need for general anesthesia, reduced blood loss and significantly lower mortality. Endovascular procedures require high surgical skills to minimize contacts between the manipulated instruments (catheters and guidewires) and the vessel wall, which represent one of the major risks for the patient. Robotic assistance can potentially improve the precision and stability of instruments manipulation. One key limitation of current commercial robotic platforms is the lack of haptic feedback, preventing their acceptance and limiting the clinical usability. This paper proposes to bring the benefit of haptic feedback to robotassisted endovascular intervention. Here we hypothesize that the introduction of 3D haptic guidance during robotassisted endovascular procedure can further improve the surgical performance and safety while overcoming the limitations of currently available technology. The proposed 3D haptic guidance allows the surgeon to sense the vasculature while controlling a catheter through a robotic haptic manipulator. Validation of the system is performed through enduser experiments with vascular surgeons on a bespoke surgical simulator. The obtained results demonstrate that 3D haptic guidance has the potential of improving effectiveness, precision, and safety of endovascular intervention. Furthermore, vascular surgeons found the proposed technology safe and overall easy to use, indicating its potential on real surgical procedures.