XCath has announced the successful first-in-human use of its EVR robotic system to treat three patients with complex brain aneurysms. These “landmark” procedures were performed at the Panama Clinic in Panama City, Panama, led by Vitor Pereira (University of Toronto, Toronto, Canada) alongside local principal investigator Anastasio Ameijeiras Sibauste, marking what the company describes as “the second time in history” that a surgical robot has been used in an intracranial neurovascular intervention.
With these procedures, the EVR system becomes “the only endovascular robotic system currently in development that has achieved intracranial navigation or neurointerventional treatment”, and also “the world’s first triaxial neurovascular robot to perform treatment”, according to a press release from XCath.
The procedures saw physicians navigate the EVR system precisely through patient brain vessels with sub-millimetre accuracy. They performed three aneurysm treatments using commercially available flow-diverting stents and intrasaccular devices made by different device manufacturers, utilising standard endovascular access devices throughout the procedures. Two robotic procedures were performed consecutively in the same operating room over a period of roughly four hours. XCath claims that this also marked the world’s first neurovascular robotic procedures with a monoplane angiographic imaging system.
“Neurovascular intervention for brain aneurysms requires operating with sub-millimetric precision, demanding exceptional control and consistency,” Pereira commented. “With the success of these aneurysm procedures, XCath’s system has demonstrated the potential to enhance human performance and bring a new level of precision to complex neurovascular cases. By standardising fine movements and decision execution, robotic assistance can help transform even junior or less experienced physicians into consistent, low-risk interventionists—ultimately improving outcomes and minimising complications.”
As stated in XCath’s recent release, intracranial navigation is both complex and challenging due to the fragile and tortuous nature of the neurovasculature, which has ultimately limited the number of physicians who can perform the necessary procedural manoeuvres to a very small group of highly skilled neurointerventionists. However, XCath’s EVR system has been designed to allow surgeons to place guidewires, catheters and treatment devices throughout the intracranial vasculature with robotic precision.
“These procedures mark a pivotal milestone in the evolution of neurointerventional care and establish Panama as a leading strategic hub for the development of new medical technologies,” said Ameijeiras. “By harnessing robotic capabilities, we can broaden global access to advanced neurovascular care, and bridge care gaps stemming from geography and access.”
“It was exciting to witness this momentous occasion,” said Fred Moll, chairman of the XCath board of directors. “The successful completion of these procedures marks a significant milestone in the world of endovascular robotics as we seek to improve outcomes for patients impacted by aneurysms and strokes. These conditions affect a significant patient population, and the ability to perform such intricate robotic interventions has the potential to revolutionise treatment for these vulnerable individuals.”
“Unlocking clinical and commercial value in neurointervention starts with making lifesaving intracranial care more replicable, more precise and more accessible when every minute counts,” added XCath chief executive officer (CEO) Eduardo Fonseca. “This milestone is a testament to the passion and dedication of our robotics, clinical and investor team. As we look to the future, the success of a trial with this level of clinical complexity lays a strong foundation for commercially viable local and telerobotic neurointerventions that improve patient outcomes.”
XCath says that its EVR system has local and telerobotic capabilities. In May 2024, the company successfully performed what it claims to be the world’s first public demonstration of a simulated, remote mechanical thrombectomy, with Pereira performing the procedure from Abu Dhabi, UAE on a simulated patient in South Korea, removing a blood clot in the brain in minutes. The telerobotic demonstration revealed low latency and a reliable connection between the robotic controller in Abu Dhabi and the robotic device in South Korea. XCath subsequently conducted an operation that it says was the world’s first telerobotic mechanical thrombectomy on an animal in February 2025.
