CRONOS: A Continuum Robot for Neurovascular Surgery — Design, Development, and Feasibility Evaluation

This work presents the design, development, and evaluation of a continuum robot for neurovascular surgery (CRONOS), addressing the lack of commercially available robots specifically designed for neurointervention. As the field evolves, assessing the feasibility of robot-assisted procedures, particularly for remote stroke treatment, is crucial. Designed for research purposes, CRONOS aims to explore the feasibility of such procedures. It features a trajectory planner, an open-source 3D-printed design, and independent control of three devices, providing four degrees of freedom. The system enables millimeter control and remote operation via a client–server network. To assess functionality, we simulated three stroke cases using a virtual system, categorizing data by operation mode: manual, robotic training, and robotic experiments. The robot was locally controlled via CAN bus during training and remotely operated in the experimental phase. Key performance metrics, including procedure success rate, device translation, and fluoroscopy time (FT), were compared to manual operations. The robotic system significantly reduced device translation, with robotic experiments showing a 52.2% decrease compared to manual mode. FT showed variability across modes, though manual procedures had the lowest values, with only a 9.7% difference from robotic experiments. These findings suggest that robot-assisted neurovascular interventions can enhance procedural control while maintaining comparable FT outcomes.