Concentric Tube Robot-Assisted Intracerebral Hemorrhage Evacuation: Validation in an Ovine Model

Intracerebral hemorrhage (ICH) is a type of hemorrhagic stroke that causes nearly 3 million deaths annually worldwide. Recent clinical trials have indicated minimally invasive surgery (MIS) can improve functional outcomes in patients with lobar ICH. However, despite these promising results challenges persist, namely, tool dexterity and visualization. Previous research has been developing a platform for MR-guided ICH evacuation using a concentric tube robot (CTR), and in this study we present the first-ever in vivo ICH evacuation with an MR-guided CTR. The CTR is a three degree of freedom (DoF) robot mounted to a 4-DoF stereotactic frame. The robot has two non-metallic concentric tubes that are pneumatically actuated. Detailed in this paper are our experimental in vivo workflow, a novel clot production method to be used in ex vivo and in vivo ICH models, and the evacuation outcomes.