Robot-assisted versus manual neuroendovascular interventions - updated systematic review and pairwise meta-analysis.

BACKGROUND: Robot-assisted (RA) procedures are emerging in the field of neuroradiology, and robots are being used in various neuroendovascular procedures, including carotid artery stenting, cerebral angiography, and mechanical thrombectomy. PURPOSE: This study aims to synthesize up-to-date knowledge on this subject and to compare RA with manual neuroendovascular procedures. DATA SOURCES: PubMed, Embase, Web of Science, and Scopus libraries were searched from inception to February 2026. STUDY SELECTION: Studies comparing RA and manual neuroendovascular interventions were included. DATA ANALYSIS: Synthesis of evidence was performed through pairwise meta-analysis utilizing a random-effects model. DATA SYNTHESIS: After a comprehensive search, this study included 6 papers. Three studies used the CorPath GRX system for the procedures. RA procedures showed significantly longer operating room time (MD 12.42 min; 95% CI 6.31 to 18.53). However, procedure and fluoroscopy times did not differ significantly. The RA group showed significantly lower contrast volume (MD -6.20 ml; 95% CI -11.91 to -0.50). Patient radiation exposure, DCA diagnostic success, procedural success, procedural access point conversion, incidence of TIA or stroke events, or overall complication rate showed no significant differences. LIMITATIONS: Currently, the review is limited by the narrow range of procedures studied. CONCLUSIONS: Exploratory results from this review suggested longer overall operating room time with robots but lower contrast volume than with conventional neuroendovascular procedures.