When treating a stroke, every second counts. But for patients in remote areas, receiving treatment may take several hours.
Standard treatment for common type ironcaused by large blood clots cutting off blood flow to the brain is a procedure called endovascular thrombectomy or EVT. During the procedure A.Experienced surgeons thread catheters through blood vessels until the blockage is accessed through a major channel, such as the femoral artery in the groin. This is usually facilitated by x-rays, which show the position of the blood vessels.
“Good results are directly related to early treatment,” says Cameron Williamsneurologist at the University of Melbourne and fellow of the Australian Stroke Alliance. In fact, “time is the brain” common refrain V stroke treatment. While the blood flow is stopped, about 2 million. neurons die every minute. This adds up to 3.6 years of typical age-related brain cell loss.
But in places as remote as Darwin in the north Australiathis treatment is not available. Instead, getting a patient to a medical center can take 6 hours or more and require an expensive airmedical transfer, Williams said. There are similar geographic challenges to access to stroke care around the world. By saving the time of transferring rural patients to hospital with the help of an on-site expert, their lives can be saved, prevented disabilityor save years of your life.
This is why there is particular interest in the possibility of emergency treatment for stroke. performed remotely by using robotics. The machines, located in small communities, could connect patients with experienced surgeons miles away, saving hours of treatment time. Two companies recently demonstrated their remote capabilities. In September, doctors in Toronto Canada performed a series of cerebral angiograms at increasingly distant distances, an EVT X-ray imaging element, eventually performing two angiograms between cities hospitals using the N1 system from Therapeutic robotics. And in October feeling the equipment facilitated the simulation of EVT between a surgeon in Jacksonville, Florida, and a cadaver with artificial blood flow in Dundee, Scotland.
“All of these stories linked together are not just proof of concept, but the realization and realization that robotic and remote interventions can be performed is approaching and will soon become a reality for many centers in rural areas,” says Victor Pereiraneurosurgeon at Unity Health who performed the procedures in Toronto.
Two approaches to remote EVT
One of the challenges of performing these remote procedures is maintaining a reliable and fast connection over long distances. “Is there a real need to do this across the Atlantic? Probably not,” says Edwardas SatkauskasCEO of Sentante. “This demonstrates the possibilities. Even this distance is feasible.” Although pPerforming the procedure remotely introduces latency and EVT speed issues.—it's urgent—doesn't rely on instant reactions, Satkauskas says.
Redundant connections should also be an important protection against lost connections. Remedy has taken measures e.g.to ensure that their robot monitors the quality of the connection and does not make any harmful movements due to a poor connection, says David BellCEO of the company.
While both companies are careful to reveal details about products and research that are still in development, there are notable differences between their approaches.
“Our device relies heavily on artificial intelligence,” Bell says. Machine learning included in the way the Remedy device manipulates guide wires and creates an information overlay on top of X-ray images for remote doctors, who can control the robot using a laptop and software interface. The long-term goal is for a surgeon to be able to quickly log into the Remedy software from a central location and interact with Remedy robots across multiple hospitals as needed.
In contrast, Sentante uses a control console that looks and feels like the catheters and guidewires surgeons are accustomed to manipulating during manual EVT, including force feedback that simulates the resistance they experience in personal use.
“It’s very intuitive to use,” says Ricardo Hanela neurosurgeon at Baptist Health in Jacksonville who led the demonstration in Centanta. The naturalistic feeling during the transatlantic procedure was accompanied by a delay of about 120 milliseconds. Hanel also serves on Centante's medical advisory board.
Sentante has yet to implement its robot's movements using artificial intelligence, although there is a plan to collect as much training data as possible, both from images and force measurements. “As we joke, we had to build complex hardware to become a software company,” says CEO Satkauskas.
Path to clinical use
Hanel expressed optimism that any control system would be easy for surgeons to master.
“I think the main limitation of robotics is that you are still dependent on interventionalists,” says Ahmet Gunkaninterventional radiologist at the University of Arizona who wrote about robots and endovascular interventions.
Depending on the system, these bedside assistants may be responsible for a variety of tasks related to preparing and communicating with the patient, sterilizing and preparing equipment, loading individual parts, and repositioning x-ray or robotic equipment. Both CEOs note that while proper training will be important, there are ways to reduce the workload healthcare providers at the patient's premises.
In the case of remote operations, “it was important for us that the robot could do it all“says Bell. Remedy was designed to handle as many procedures as possible and optimize the moments when human interaction is needed at the bedside. For example, even since the old version was used in Toronto, changes have been made to maintain a clear line of communication between bedridden and remote clinicians, which the Remedy system facilitates,” says Bell.
A team at St. Michael's Hospital performs the world's first robot-assisted neurovascular procedure remotely over a network connection in Toronto, Canada, August 28, 2025. Katie Cooper and Kevin Van Passen/Unity Health Toronto
Although remote EVT has a high priority, systems capable of performing this procedure may first be approved for use. other endovascular procedures runs locally. The hope is that precision robotics will lead to improved patient outcomes, whether the surgeon is in the next room or in the next county.
Remedy is planning clinical trials for local neurointerventions in 2026 and is collaborating with Australian Stroke Alliance distribute its N1 system and conduct future clinical trials of remote procedures. The robot could eventually be used to treat up to 30 different diseases, Bell said.
Satkauskas envisions the Sentante equipment as a flexible platform for endovascular procedures throughout the body that can help bedside physicians become familiar with the device. The system could enter the EU market next year for peripheral vascular interventions that restore blood flow to the extremities. revolutionary device designation from USA FDA for remote treatment of stroke.
There are other players in the space. For example, one of the first developments of telerobots from Corindus. still going on after its acquisition Siemens in 2019. And Pereira notes that Kkat also demonstrated long distance EVT simulation and hopes to perform local robotic EVT on live patients in the near future.
“I think it’s an interesting time to be a neurointerventionist,” Hanel says.
Articles from your site
Related articles on the Internet
