Improving access to life-saving health care
For stroke patients who need emergency clot removal, time is of the essence. Every second not at the hospital drastically increases the chances of long-term effects and even death.
A specific procedure called mechanical thrombectomy can reverse a stroke if performed quickly; however, only 12% of eligible patients receive it. Why? Because there are only 311 hospitals in the United States equipped to do it, leaving most Americans more than an hour away from potentially life-saving care.
A mechanical thrombectomy is also a complicated procedure, requiring highly trained specialists to manually navigate catheters through blood vessels using mostly guesswork based on imaging.
To increase access to this procedure, engineers at Boston University are part of a $39.5 million consortium funded by the U.S. Advanced Research Projects Agency for Health (ARPA-H) Autonomous Interventions and Robotics (AIR) program.
Led by Associate Professor Sheila Russo (ME, MSE) and Associate Professor Tommaso Ranzani (ME, MSE), BU’s role is to develop a smarter catheter—a thin tube that combines multiple functions into one tool, a kind of Swiss Army knife for stroke treatment. The catheter would:
- Navigate on its own. Using soft, flexible actuators that match the compliance of blood vessels, the tip can bend and steer through tight turns without causing injury
- Perceive where it’s going. An embedded optical sensor gives real-time feedback on the catheter’s shape and position
- Break apart the clot. A tiny spinning rotor grinds down the blood clot, compacting it into a removable piece
- Reduce complications. A small balloon helps prevent loose clot fragments from traveling to the brain and causing further damage
A key innovation: all four capabilities are built into a single device, so doctors don’t have to swap out multiple tools during the procedure. This feature can be particularly advantageous to enable autonomy.
Over five years, the team will move through testing stages—starting with bench testing individual components, then validating how everything works together in realistic models of blood vessels, and finally testing in cadavers to confirm safety. The ultimate goal is a device that works so reliably and automatically that it could eventually be used in community hospitals far from major medical centers, not just in specialized stroke centers. A community hospital with basic equipment could potentially perform the procedure with the robot doing much of the heavy lifting.
“That could mean thousands more stroke patients get treated in time each year—potentially expanding treatment from about 40,000 cases annually to over 160,000. It’s about bringing expert-level care to places that never had it before,” said Ranzani.
“What makes this work exciting is that it tackles a fundamental healthcare inequity: right now, where you have a stroke determines whether you survive it or face lifelong disability,” said Russo. “This project aims to change that by automating and decentralizing a procedure that’s been locked in specialized centers.”
The collaboration includes Johns Hopkins University and Philips. “We are building the ‘body’ of the robot here at BU, while Johns Hopkins handles the autonomy and decision-making, and Philips integrates it all into an imaging platform,” said Ranzani.