Remote robotic-assisted endovascular interventions require real-time control of the
robotic system to conduct precise device navigation. The delay (latency) between the
input command and the catheter response can be affected by factors such as network
speed and distance. This study evaluated the effect of network latency on robotic-assisted
endovascular navigation in three vascular beds using in-vivo experimental model. Three
operators performed femoral, carotid, and coronary endovascular robotic navigation
blinded from the hybrid room with the prototype remote-enabled CorPath GRX system
in a porcine model. Navigation was performed to different targets with randomly assigned
network latencies from 0 to 1000 ms. Outcome measurements included navigation success,
navigation time, perceived lag (1 = imperceptible, 5 = too long), and procedural impact
scored by the operators (1 = no impact, 5 = unacceptable). Robotic-assisted remote
endovascular navigation was successful in all 65 cases (9 femoral, 38 external carotid,
18 coronary). Guidewire times were not significantly different across the simulated
network latency times. Compared to 0 ms added latency, both the procedural impact
and perceived lag scores were significantly higher when the added latency was 400
ms or greater (< 0.01). Remote endovascular intervention was feasible in all studied
anatomic regions. Network latency of 400 ms or above is perceptible, although acceptable
to operators, which suggests that remote robotic-assisted femoral, carotid or coronary
arterial interventions should be performed with network latency below 400 ms to provide
seamless remote device control.
