Evolution and current state of robotic catheters for endovascular surgery: A comprehensive review

For the past decade, a number of robotic catheters have been developed for precise and repeatable insertion of endovascular catheters and guidewires. However, using the existing descriptions of a variety of designs and functions it is impossible to systematically evaluate the development of robotic catheters and follow their modifications that lead to improvements in their performance. This systematic literature review focuses on the evolution of robotic catheters in order to define the current results and trends in this field. We have followed the PRISMA guidelines and conducted a comprehensive search of publications reporting design and feasibility tests from January 2011 to December 2023 in the Google Scholar database. The evolution of each model was described in terms of the implemented mechanisms and features. The accuracy, ranges of motion and speed of robotic catheters were compared. The most common number of degrees of freedom of the slave unit of robotic catheters is 2-3. Robotic catheters usually have unlimited translation and rotation ranges, and the speed range varies from 2 to 20 mm/s for translation and from 8 °/s to 20 °/s or from 50 °/s to 70 °/s for rotation. The major part of robotic catheters has the maximum translational trueness between 0.5 and 1.1 mm, and the maximum rotational trueness is between 0.8°and 1.2°, which is enough to execute a precise endovascular procedure. No commercially available robotic catheter has force feedback, however, many of the catheters are developing various elements for it, which suggests that such systems will appear in the future.