Single-Use Handheld Vascular Robotics: What Is the Future?

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During a Tuesday morning session at ISET 2026, Ripal T. Gandhi, MD, FSIR, FSVM from Miami Vascular Specialists in Florida, explored how single-use, handheld robotic systems could shape the next phase of peripheral endovascular intervention. He walked through both the promise and the practical realities of robotic navigation in today’s cath lab.

The presentation centered on a fundamental question: why robotics, and why now? As procedures become more complex and operator demands continue to grow, robotic assistance offers a potential solution to challenges many clinicians face daily. Dr Gandhi highlighted how robotic navigation may improve precision and predictability while reducing radiation exposure, contrast use, and operator fatigue. He also emphasized the potential for robotics to help standardize performance across operators, particularly earlier in training, helping to “level the playing field” in technically demanding cases.

A major focus of the session was the LIBERTY Robotic System (Microbot Medical), the first FDA-cleared, single-use, remotely operated robotic platform designed specifically for peripheral endovascular procedures. Unlike larger, capital-intensive robotic systems, LIBERTY is intended to be used at the bedside and only during the navigation phase of the procedure. The system allows physicians to remotely advance, retract, and rotate standard guidewires and microcatheters through a handheld controller, while maintaining the ability to switch back to manual control instantly and without removing devices from the patient.

Dr Gandhi underscored that workflow integration and safety are critical to adoption. The system incorporates multiple safeguards, including proximity sensors, visual and tactile alerts, and an immediate abort function. Setup is designed to be flexible and minimally disruptive, allowing operators to transition between robotic and manual techniques as needed during a case.

The presentation also reviewed the data supporting the technology. In preclinical GLP animal studies, robotic navigation demonstrated safety and performance equivalent to manual catheterization, with no device-related complications. Dr Gandhi also discussed early clinical experience from the ACCESS-PVI first-in-human study, which is evaluating the feasibility and safety of remote-controlled peripheral vascular navigation in patients undergoing elective interventions. These findings supported FDA 510(k) clearance for the LIBERTY system in September 2025.

Looking ahead, Dr Gandhi placed single-use robotics within the broader evolution of endovascular care. He highlighted early examples of successful long-distance tele-robotic interventions and discussed how future systems may incorporate artificial intelligence, machine learning, and predictive analytics to further support decision-making. While fully autonomous robotic procedures remain a longer-term goal, he emphasized the importance of continued clinical evidence, thoughtful adoption, and ethical consideration as these technologies advance.