The landmark mechanical thrombectomy procedure took place through a clinical investigation termed Operation Robo Angel. Dr. Vitor Mendes Pereira performed the procedure in Clinica Norte in Santiago, Panama. He performed the thrombectomy more than 120 miles away from the patient in Panama City.
Iris, a robotic endovascular system, has been labeled by the company as the only endovascular robotic system currently in development to achieve intracranial navigation or neurointerventional treatment. It also called it the only robot in the world to perform an intracranial neurovascular procedure involving the robotic manipulation of three devices and the only system to have operated using standard monoplane imaging equipment.
XCath reported the first human use of Iris in November 2025. Now, it says that the telesurgery case demonstrated precision in navigating and delivering therapeutic devices over a long-distance connection. The case also had no perceptible latency over the course of the successful mechanical thrombectomy procedure.
This marks the latest milestone for XCath, which earlier this month announced $30 million in funding, co-led by board chair Fred Moll, considered the “father of surgical robotics.”
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More about the telerobotic procedure
XCath said the case involved a male patient in his late 60s presenting with acute stroke symptoms. The patient initially arrived at a referring hospital. There, diagnostic imaging confirmed a large vessel occlusion (LVO) of the left middle cerebral artery. Next, the patient was rapidly transferred to the Panama Clinic, a primary treatment center.
At Panama Clinic, doctors determined that the patient’s symptoms indicated a severe stroke and high likelihood of death or devastating disability without rapid intervention. Upon arrival, the patient immediately went to the operating suite for the telerobotic endovascular surgery.
Total transfer time between sites took 15 minutes. During this time, the onsite clinical team prepared the procedure room with Iris and established connectivity with the remote team and operator.
Using Iris, the remote operator robotically navigated therapeutic devices through the intracranial vasculature to the site of occlusion. The operator performed the mechanical thrombectomy utilizing a stent retriever and balloon occlusion with dual aspiration.
XCath said the operator removed the clot successfully on the first pass, achieving complete reperfusion of the affected vessel. A post-procedure evaluation of the patient showed improvement in both general condition and neurological functions. At 24 hours, the patient continued to progress.
According to XCath, the patient is expected to make a complete recovery.
Commentary from XCath officials and doctors
Eduardo Fonseca, CEO of XCath, said:
“The world’s first telerobotic neurosurgery was made possible by an exceptional team working alongside more than 60 physicians across five hospitals, all united around a single priority: patients,” said Eduardo Fonseca, CEO of XCath. “The true legacy of this moment will be measured in the millions of lives that could be saved each year as stroke treatment reaches patients who today have no access to it.”
Dr. Vitor Mendes Pereira said:
“Mechanical thrombectomy is proven to reduce mortality and disability in patients with ischemic stroke but unfortunately access to the procedure is extremely low. The work XCath has done with the Iris System is a giant step toward broadening access to mechanical thrombectomy for patients around the world,” Dr. Vitor Mendes Pereira said. “The experience of performing the first-in-human procedure matched the successful simulated procedures we previously performed with the team, with imperceptibly low latency and no disruptions to the surgical workflow. It is the highlight of my career to be involved in this historic achievement.”
Dr. Fred Moll said:
“XCath has accomplished what no other company has achieved in stroke care: a successful remote robotic mechanical thrombectomy delivering lifesaving treatment to a patient that would have otherwise not been able to receive treatment. It was a privilege to be present in this historic moment,” said Dr. Fred Moll, Chairman of XCath. “I believe that the XCath system will help create a new standard of care for stroke patients around the world.”
