For stroke care, speed is everything. Yet for millions of people living far from major medical centers, access to life-saving treatment can take hours, often with devastating consequences. A new generation of robotic and telerobotic systems aims to change that. By enabling expert neuro-interventionalists to perform emergency procedures across vast distances, these technologies could dramatically improve access to endovascular thrombectomy (EVT), the gold-standard treatment for large-vessel strokes.
In regions like northern Australia, patients may wait six hours or more before reaching a specialist. “Time is brain,” notes neurologist Cameron Williams of the Australian Stroke Alliance. Each minute of blocked blood flow destroys an estimated two million neurons. Remote robotics, he argues, could eliminate critical delays by bringing expertise virtually to the bedside.
Recent advancements
Recent demonstrations highlight how rapidly the field is advancing. In Toronto, neurosurgeons used Remedy Robotics’ N1 system to perform increasingly distant remote brain angiograms, while Sentante facilitated a simulated EVT between Florida and Scotland. These proofs of concept show that long-distance, high-precision vascular procedures are not only technically feasible but increasingly reliable.
The two approaches differ in philosophy. Remedy integrates AI-driven assistance, safe-motion algorithms and remote control through a software interface, with a long-term vision of central “stroke command centers” overseeing multiple hospital robots. Sentante, by contrast, focuses on natural haptic feedback and familiar catheter-like controls, helping surgeons transition smoothly to robotic workflows even with measurable latency.
Challenges
Connectivity, safety and workflow integration remain challenges. Both systems incorporate safeguards against signal loss, redundant communication pathways and strict movement control to prevent unintended actions. Bedside support remains crucial for patient preparation and equipment handling, but vendors aim to automate as much of the procedure as possible to reduce workload in resource-limited settings.
Clinical adoption will be incremental. Robots suited for EVT may first be approved for other endovascular procedures, while global trials are underway. Remedy plans a neurointervention trial in 2026 in partnership with the Australian Stroke Alliance, and Sentante expects EU market entry for peripheral vascular interventions as early as next year. Regulatory pathways are also opening, with the U.S. FDA granting breakthrough designation for remote stroke treatment.
Multiple companies, including Corindus and Xcath, are expanding the ecosystem, signaling a new era in neurovascular care. As neurosurgeon Ricardo Hanel observes, “It’s an exciting time to be a neurointerventionalist.” Remote robotics may soon transform stroke care from a matter of geography to one of connection, bringing advanced treatment closer to every patient, wherever they live.
Improving stroke care
Earlier this year researchers at Erasmus MC developed a simulation model showing that a mobile stroke unit (MSU) could significantly accelerate and improve stroke care in the Rotterdam region. Because stroke damage progresses rapidly, early diagnosis is critical, but today, patients often face delays, as a CT scan is required to distinguish between a clot and a haemorrhage and can only be performed in hospital.
The MSU solves this bottleneck by bringing imaging and specialist expertise to the patient. The vehicle is equipped with a CT scanner, dedicated equipment and a specially trained nurse who assesses the patient, consults a neurologist remotely and can start treatment immediately. Patients are then taken directly to the most appropriate hospital.
According to the model, an MSU available daily from 7:00 to 23:00 with a 25-minute response time could start treatment 10 to 50 minutes earlier, saving lives and reducing disability. It also reduces hospital and ambulance workload and is expected to pay for itself within two years. A regional pilot is now being prepared.
Philips and Medtronic have also been working together (article in Dutch) globally in the field of stroke care for some time. Together, they have expressed their ambition to improve access to timely diagnosis and treatment of strokes worldwide. They also collaborate with the WSO (World Stroke Organisation) and joined the WSO Advocacy Coalition last year. Led by the WSO, this coalition brings together a wide range of parties, including healthcare professionals, patient groups and policymakers, to develop strategies to address the global impact of strokes.
