Researchers at King's College London have helped establish the first international consensus on how to design, test and evaluate robotic systems for stroke treatment.
Until now, no agreed framework existed for how robotic systems for mechanical thrombectomy (MT) should be built, tested or evaluated. A new position statement, published in the Journal of the American Heart Association (JAHA), fills that gap, defining standards that put patient safety first.
MT is a life-saving procedure used to remove blood clots from the brain. The complex procedure is needed within hours to achieve the best outcomes, but as it requires specialist expertise, access remains limited.
Robotic surgical systems could expand access to MT by enabling specialists to perform procedures remotely. However, progress has been hampered by a lack of standardisation across studies.
"In 2023, we carried out a systematic review of endovascular robotics and autonomy," said Harry Robertshaw, first author and PhD student at the School of Biomedical Engineering & Imaging Sciences. "We found that although several studies existed, they were all testing different tasks, using different models and measuring different outcomes. This made it impossible to compare results or identify the most effective approaches."
To address this, the team brought together an international group of experts in interventional neuroradiology, robotics, data science, health economics, policy, statistics and patient advocacy to establish consensus frameworks for developing and validating robotic MT. The resulting position statement sets out how the systems should be tested and how their effectiveness should be measured and reported.
By bringing together experts from clinical practice, academia, industry and patient representatives, we have defined the first consensus standards for robotics and AI in thrombectomy navigation. This will help to move the technology forward as its integration with clinical practice moves closer to reality.
Harry Robertshaw, PhD student at the School of Biomedical Engineering & Imaging Sciences
Patient perspectives were key, with input from patient representatives and organisations including the Stroke Association. This helped ensure that safety, real-world impact and patient benefit remain central.
The researchers hope the position statement will drive more comparable studies, accelerating progress across the field.
Senior author Dr Thomas Booth commented: "While AI-assisted robotic MT is not yet ready for routine clinical use, the speed of innovation in both robotics and AI means transformative advances are likely to be just around the corner. Our work lays the foundation for that future by defining clear standards to ensure that global development and validation are well understood."
By establishing practical, consensus-driven recommendations, we are helping to ensure that when these technologies do reach patients, they do so safely, responsibly and with meaningful clinical benefit.
Dr Thomas Booth, Reader in Neuroimaging at King's College London and Consultant Diagnostic and Interventional Neuroradiologist at King's College Hospital
The position statement is already being put to use, with the King's team recently demonstrating for the first time that AI can autonomously perform MT navigation in a physical lab setting. The frameworks will guide how that work is developed, validated and eventually brought into clinical trials.
