应用自主研发的远程控制血管腔内手术机器人系统完成动脉造影手术，并评价其有效性及安 全性。 方法：使用三维人体血管模型及巴马小型猪，在 DSA（Digital subtraction angiography，DSA）下远程控制血管 腔内手术机器人操控导管自股动脉入路进入血管模型及实验动物的主动脉弓和三级血管，完成猪全脑血管造影，并 对标记部位行组织切片，评价系统有效性及安全性。结果：血管腔内手术机器人可成功进入体外模型主动脉弓及三 级血管分支，并在体内研究中成功完成猪全脑血管造影，术后猪主动脉弓及各标记部位组织切片中血管内膜未见明 显损伤。结论：本研究证实远程控制腔内机器人系统可在动物模型中成功完成弓上动脉及全脑血管造影，超选目标 血管及造影过程安全有效。

To evaluate the effectiveness and safety on a self-developed remote-control endovascular robot in supra-arch arteries selection and angiography operation. Methods: The endovascular robotic system is controlled remotely to direct the catheter from femoral access to aortic arch and supra-arch tertiary vessels in a three-dimensional human vascular model and Bama mini-pigs to complete cerebral angiography under fluoroscopy of DSA. Pathological examination of arterial tissue at marked sites was performed to evaluate the safety. Results: The endovascular robot can successfully enter the aortic arch and supra-arch tertiary vessels in vitro model and complete the porcine cerebral angiography. Postoperative porcine aortic arch and supra-arch vascular tissue pathological examination showed no obvious injury on arterial intima in areas of interest. Conclusion: This study confirmed that remotely controlled endovascular robot can successfully perform supra-arch arteries and cerebral angiography in vascular and animal model. The experimental process of super-selection and angiography is safe and effective.

收稿日期：2020-03-02  录用日期：2020-07-21 

Received Date: 2020-03-02  Accepted Date: 2020-07-21 

基金项目：浦东新区科技发展基金创新资金（PKJ2012-Y68）；上海市重点专科项目（ZK2019A10） 

Foundation Item: Shanghai Pudong District Science Project(PKJ2012-Y68); Program for Medical Key Department of Shanghai (ZK2019A10) 

通讯作者：余波，Email：paul.yubo@gmail.com 

Corresponding Author: Yu Bo, Email: paul.yubo@gmail.com 

引用格式：谭晋韵，贾罗琦，史伟浩， 等 . 腔内手术机器人在主动脉弓上血管造影中的应用及安全性评价 [J]. 机器人外科学杂志， 2020，1（4）：250-257. 

Citation: TAN J Y, JIA L Q, SHI W H, et al. Evaluation of effectiveness and safety on remote-control endovascular robot in supraarch arterial angiography [J]. Chinese Journal of Robotic Surgery, 2020,1(4):250-257.

[1] Kirkwood M L, Arbique G, Guild J B, et al. Radiation brain dose to vascular surgeons during fluoroscopically guided interventions is not effectively reduced by wearing lead equivalent surgical caps[J]. Journal of Vascular Surgery, 2017, 68(2): 567-571. 

[2] Hertault A, Maurel B, Midulla M, et al. Editor’s ChoiceMinimizing Radiation Exposure During Endovascular Procedures: Basic Knowledge, Literature Review, and Reporting Standards[J]. European Journal of Vascular and Endovascular Surgery, 2015, 50(1): 21-36. 

[3] Panesar S S, Britz G W. Endovascular Robotics: The Future of Cerebrovascular Surgery[J]. World Neurosurgery, 2019. DOI: 10. 1016/j. wneu. 2019. 06. 126. 

[4] 我国达芬奇机器人手术统计数据 [J]. 中国胸心血管 外科临床杂志 , 2015, 22(8): 743. 

[5] 吴志远 , 李拥军 . 达芬奇机器人系统在血管外科 的应用现状 [J]. 中国普外基础与临床杂志 , 2016, 23(9): 1142-1145. 

[6] 谭晋韵 , 贾罗琦 , 史伟浩 , 等 . 血管介入远程数控 机器人系统在血管造影中的体内外实验观察 [J]. 中 华医学杂志 , 2016, 96(42): 3412-3416.

[7] Aagaard P, Natale A, Biase L D, et al. Robotic navigation for catheter ablation: benefits and challenges[J]. Expert Review of Medical Devices, 2015, 12(4): 457-469. 

[8] Carpi F, Pappone C. Stereotaxis Niobe® magnetic navigation system for endocardial catheter ablation and gastrointestinal capsule endoscopy[J]. Expert Review of Medical Devices, 2009, 6(5): 487-498. 

[9] Gang E S, Nguyen B L, Shachar Y, et al. Dynamically Shaped Magnetic Fields Clinical Perspective[J]. Circulation-arrhythmia and Electrophysiology, 2011, 4(5): 770-777. 

[10] Dunn J, Han S M, Weaver F A, et al. Early Clinical Experience with the MagellanTM Robotic System for Endovascular Procedures[J]. Annals of Vascular Surgery, 2015, 29(5): 879. 

[11] Giudice C D, Pellerin O, Neville M N, et al. Comparison of Two Endovascular Steerable Robotic Catheters for Percutaneous Robot-Assisted Fibroid Embolization[J]. CardioVascular and Interventional Radiology, 2018, 41(3): 483-488. 

[12] Khan E M, Frumkin W I, Ng G A, et al. First experience with a novel robotic remote catheter system: Amigo™ mapping trial[J]. Journal of Interventional Cardiac Electrophysiology, 2013, 37(2): 121-129. 

[13] Mahmud E, Naghi J, Ang L, et al. Demonstration of the Safety and Feasibility of Robotically Assisted Percutaneous Coronary Intervention in Complex Coronary Lesions: Results of the CORA-PCI Study (Complex Robotically Assisted Percutaneous Coronary Intervention)[J]. Jacc-cardiovascular Interventions, 2017, 10(13): 1320-1327. 

[14] 宋晨曦 , 杨伟宪 , 丰雷 , 等 . 亚洲首例机器人辅助经 皮冠状动脉介入治疗报道 [J]. 中国循环杂志 , 2018, 33(12): 1237-1238. 

[15] 陈政 , 沈毓 , 陆清声 , 等 . 新型血管介入机器人应用 可行性初探 [J]. 介入放射学杂志 , 2018, 27(7): 651- 654. 

[16] 徐武夷 , 卢旺盛 , 刘达 , 等 . 血管介入机器人临床 应用报告 [J]. 中国血管外科杂志 ( 电子版 ), 2014, 6(1): 16-18. 

[17] 曹彤 , 王栋 , 刘达 , 等 . 主从式遥操作血管介入机 器人 [J]. 东北大学学报 ( 自然科学版 ), 2014, 35(4): 569-573. 

[18] 陆清声 . 血管腔内介入手术机器人的探讨 [J]. 中国 血管外科杂志 ( 电子版 ), 2018, 10(4): 237-239. 

[19] Lumsden A B, Bismuth J. Current status of endovascular catheter robotics[J]. Journal of Cardiovascular Surgery, 2018, 59(3): 310-316.