Robotic Transducer Control During High Intensity Focused Ultrasound Treatment of Atherosclerosis

To investigate the feasibility of targeting atherosclerotic plaques noninvasively using a high intensity focused ultrasound transducer and a six degrees of freedom robot. Custom robot control software was designed and implemented, enabling 3D transducer translations and orientations in the three orthogonal directions (x, y and z), as well as monitoring and visualization of the HIFU ablation positions. The accuracy and repeatability of the robot and software were investigated with the exerted force by the robot’s distal end. In nine animal experiments, the feasibility of robotic transducer control during noninvasive HIFU surgery for atherosclerotic plaque targeting was demonstrated. A retrospective study on patients previously treated with PTA, stenting or surgical revascularization was performed to determine which patients and artery trajectories are most suitable for HIFU surgery. Results 2D and 3D visualizations of each HIFU ablation position, and real-time distance feedback for subsequent ablations was implemented. The feasibility of robotic transducer positioning with custom robot control software was demonstrated. This research is a first step towards the clinical implementation of the robotic HIFU surgery approach for atherosclerosis, and we hope that it may eventually lead to a standardized noninvasive treatment option for patients suffering from PAD.