Kitware and UNC Aim to Bring Robotic Stroke Care Closer to Patients

UNC School of Medicine supports robotic stroke innovation to help advance care for patients experiencing brain blood vessel disorders.

As stroke treatment advances, hospitals depend on specialists who can perform complex, minimally invasive procedures inside the brain's blood vessels. The challenge is that the need for these procedures far exceeds the number of physicians available to provide them. Access to these interventions is limited, and many patients travel hours or fly across the state to receive care.

A new project aims to change that. The three and a half year Testbed for Autonomous Interventions and Robotics (AIR), led by ARPA-H Program Manager Ileana Hancu, Ph.D., brings together researchers from Kitware, the UNC School of Medicine, Johns Hopkins University, the University of North Carolina, the University of Pittsburgh, Florida State University, and Lightside Surgical, Inc. An award of up to $17.5 million by the Advanced Research Projects Agency for Health (ARPA-H), an agency within the U.S. Department of Health and Human Services, will be utilized to develop an open-source virtual testing platform for robotic stroke interventions. The funding will support the creation of a simulation environment to test and evaluate robotic algorithms designed to assist with endovascular stroke treatment.

The overall goal is to develop an endovascular robot capable of navigating a catheter through the bloodstream to perform procedures to treat conditions like stroke, aneurysm, and certain brain hemorrhages. UNC School of Medicine's Yueh Lee, MD, PhD, professor of radiology and clinical lead, shares that this new simulation software will accelerate the development of these robotic tools to improve access and expedite care for all patients.

"That's one of the reasons we are excited to help develop open-source software tools to reduce barriers to entry," said Lee, vice chair of translational research in the Department of Radiology. "More importantly, this will help accelerate the development of these tools, which could substantially expand access to stroke thrombectomy for patients. Imagine a robot that could perform the procedure at any hospital without requiring the patient to be transferred to a major medical center." Lee is also an adjunct professor in the Department of Physics and Astronomy and the Lampe Joint Department of Biomedical Engineering.

As the clinical lead of the project, Lee and his team will provide medical imaging data to support testing the intervention digitally. James Ho, MD, assistant professor of neurology and director of UNC Medical Center's Comprehensive Stroke Center, will serve as co-investigator.

"A stroke occurs when there is a blockage of the blood vessels in the brain, usually from a blood clot," said Ho, who is also a Neurointerventionalist at the UNC School of Medicine. "The longer that blood clot stays in place, the more brain tissue loses oxygen and nutrients it needs to survive. It's estimated that every minute during a stroke, nearly 2 million brain cells die. Twenty years ago, we didn't have a lot of good options for these patients; however, we are now able to go inside of the blood vessels, remove the blood clot, and restore blood flow to the brain. This has made a huge impact on patients."

Dr. Ho adds that the missing piece of the puzzle is timely access to this intervention. Because this procedure is only done by highly trained specialists, many patients have to be flown across the state to receive this life saving intervention, which further adds to the time it takes before the blockage can be removed. This project has the potential to enhance a Neurointerventionalist's ability to take care of patients regardless of where they had their stroke. Another critical advantage is that this procedure is minimally invasive with a shorter recovery time compared to traditional open-brain surgery, and this robotics platform could potentially provide greater access to these procedures to patients.

The team will be working with faculty at the University of Pittsburgh and other institutions to receive their data contributions. Lee shares that this work builds on the strong clinical care provided by UNC Hospitals Comprehensive Stroke Center and the dedication to provide high-quality neuroradiology imaging, high-quality neurovascular care, and a strong translational research environment for the project.

Acknowledgment and disclaimer: "This research is funded, in part, by the Advanced Research Projects Agency for Health (ARPA-H). The views and conclusions contained in this document are those of the authors and should not be interpreted as representing the official policies, either expressed or implied, of the U.S. Government."

Media contact: Brittany Phillips, Communications Specialist, UNC Health | UNC School of Medicine