Remote Robotic Stroke Treatment: Building a Canadian Pathway from Teleoperation to Life-Saving Intervention: CRC'26 Symposium

Dr. Vitor Mendes Pereira is a clinician-scientist and Professor in the Division of Neurosurgery at the University of Toronto, specializing in endovascular neurosurgery and the treatment of intracranial aneurysms and acute ischemic stroke. His research integrates robotics, artificial intelligence, imaging science, and vascular biology to improve outcomes and expand access to neurovascular care.

At St. Michael’s Hospital, Unity Health Toronto, Dr. Pereira leads the internationally recognized RADIS Lab (Robotics and AI in Diagnostic Imaging and Surgery). In 2019, his team performed the world’s first robot-assisted therapeutic neurointerventional procedure. In 2025, the lab achieved another world first by completing a remotely performed robotic-assisted neurovascular diagnostic procedure across separate institutions.

Dr. Pereira also led Operation RoboAngel in Panama, which achieved the world’s first telerobotic mechanical thrombectomy in a stroke patient, demonstrating the potential to deliver lifesaving treatment across geographic barriers. His team has contributed to the development of CRONOS, a robotic platform designed for remote stroke thrombectomy, and established foundational benchmarks for safe long-distance intervention.

A contributor to landmark trials including SWIFT PRIME and SWIFT DIRECT, Dr. Pereira also investigates aneurysm growth and rupture, advancing risk prediction, innovative therapies, and precision cerebrovascular care worldwide through ongoing collaborative research, clinical innovation, and mentorship

Location of Deployment:	Toronto, Canada
End-User Details	Rural, Remote, and Underserved Patient Populations & Provincial Healthcare Systems
Sector:	Healthcare
Project Description:	Stroke treatment is extraordinarily time-sensitive. For patients experiencing an acute ischemic stroke caused by a large-vessel occlusion, endovascular thrombectomy (EVT) can dramatically reduce permanent disability when performed rapidly. However, access remains concentrated in specialized urban centres, leaving many patients in rural, remote, and underserved Canadian communities dependent on lengthy transfers. Stroke creates billions of dollars in healthcare expenditures, rehabilitation needs, lost productivity, and long-term disability costs in Canada. Expanding timely access to EVT therefore represents not only a clinical priority, but also a major health-economic opportunity. This case study presents the development of a remote robotic neurointerventional program designed to bring specialist expertise to the patient rather than transporting every patient to the specialist: Translational Step (Canada): A foundational Canadian milestone was the successful performance of remote robotic diagnostic cerebral angiography between St. Joseph’s Health Centre and St. Michael’s Hospital in Toronto, with the patient and procedural team at one hospital and the neurointerventional physician operating from the other. Although diagnostic angiography does not itself treat a stroke, it was an essential translational step. It demonstrated secure connectivity, reliable robotic catheter and guidewire control, real-time communication, patient monitoring, coordination between local and remote clinical teams, and clearly defined emergency and manual-transition workflows within an integrated Canadian hospital system. Therapeutic Step (Panama): Building on this foundation, the ROBOANGEL Panama operation subsequently demonstrated remote robotic mechanical thrombectomy across an approximately 200-kilometre network. The procedure achieved successful reperfusion and provided important real-world evidence that the workflows developed for remote neurointervention can progress from diagnosis to time-critical stroke treatment. The next objective is to continue this work in Canada through further clinical validation, regulatory engagement, partner-hospital development, staff training, standardized workflows, and a scalable hub-and-spoke implementation model. The long-term vision is a Canadian network of robotics-enabled regional hospitals through which expert neurointerventionalists can remotely support and treat patients — transforming geography from a barrier to stroke care into a challenge that technology can help overcome.

Clinical & Technological Milestones: Successfully performed remote robotic diagnostic cerebral angiography between St. Joseph’s Health Centre and St. Michael’s Hospital in Toronto, followed by the world's first remote robotic mechanical thrombectomy across ~200 km in Panama, demonstrating successful reperfusion and establishing benchmarks for safe long-distance neurointervention.
Validated Operational & Safety Workflows: Proven demonstration of secure connectivity, reliable robotic catheter and guidewire control, real-time communication, patient monitoring, team coordination, and clearly defined emergency and manual-transition workflows within an integrated hospital network.
Scalable Health-Economic Pathway: Established the blueprint for a Canadian network of robotics-enabled regional hospitals supported by a dedicated health-economic analysis estimating additional Canadians receiving timely EVT, treatment delays and interhospital transfers avoided, reductions in long-term disability and institutional care, and potential annual savings for provincial healthcare systems.

Project Overview

Key Outcomes

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