**4.4 Carotid and neurointerventions**

Robotic-assisted carotid artery stenting is the boundary of peripheral and neurointerventions. A recently published prospective feasibility study enrolled 13 patients who underwent this procedure. They reported technical success in all of the 13 cases, without postoperative neurological complications using the Magellan system [27].

The CorPath system underwent several modifications to become applicable in the field of neurointerventions. One of these modifications is the additional Y-adapter that enables the use of additional microcatheters, another modification is the active device fixation, which allows the operator to maintain guidewire position during catheter movements. Active guide catheter control also supports vessel cannulation [28]. A preclinical feasibility study on a porcine model was conducted to prove safe robotic navigation in neurovasculature sized vessels of the pig [29]. Based on this trial the use of the CorPath GRX system was authorized in New-Zealand, Australia and the European Union. Although the first-in-human use of the robotic system happened in Canada, when a basilar aneurysm was treated with robotic support [30]. Britz et al. used the GRX system to treat arterio-venous malformation by embolization in a pig model [31].
