Jiyuan Zhao

Yanxi Chen, Tianliang Yao, Shaolong Tang et al.

Endovascular interventions are high-stakes procedures requiring precise device operation within complex and tortuous vascular anatomies. Autonomous endovascular navigation has the potential to standardize procedural quality and reduce the performance variability inherent in manual operation. Although Reinforcement Learning (RL) approaches have demonstrated promise in enabling autonomy in endovascular intervention, they often struggle with explicit constraint satisfaction and safety guarantees. To address these challenges, a learning-based expert strategy is introduced, enhancing procedural consistency in autonomous endovascular intervention by explicitly decoupling high-level strategic decision-making from low-level procedural execution. The proposed framework replicates the expert clinical decision-making process: a strategic RL policy generates global navigation intents, which are subsequently refined through an expert-informed execution module. This module ensures that robot movements strictly adhere to expert operational norms, real-time kinematic limits, and vessel safety constraints. Experimental evaluation across high-fidelity 3D simulations and a real-world robotic platform demonstrates that the proposed framework not only outperforms baseline policies but also effectively replicates expert-level proficiency. The framework achieves a high navigation success rate (> 96%) and a 29.3% reduction in operational steps, which translates to enhanced operative efficiency and minimized device-vessel interaction. Furthermore, a 13% reduction in trajectory variance indicates superior procedural standardization, aligning autonomous behavior with established clinical norms. These results underscore its potential to enhance the predictability, safety, and consistency of robotic endovascular interventions.

Wentong Tian, Jiyuan Zhao, Tianliang Yao et al.

Robotic-assisted endovascular interventions demand accurate, stable, and context-aware guidewire navigation in complex and patient-specific vascular anatomies. Despite recent advances in robotic precision and learning-based control, existing autonomous navigation methods remain limited by their reliance on static reward functions and the lack of explicit procedural reasoning regarding anatomical context and task progression. To address these challenges, this paper proposes a vision-language procedural reasoning (VL-PR) framework for autonomous guidewire navigation. The framework integrates a multimodal large language model (MLLM) as a procedural reasoning module that interprets real-time visual observations to infer high-level navigation contexts. Instead of generating low-level control commands, the inferred procedural insights enable context-aware reward adaptation by dynamically adjusting the importance of reward components across different navigation phases. This approach allows a single policy to resolve competing objectives and handle complex transitions while preserving a consistent global task goal. Experiments on a physical robotic platform across diverse vascular scenarios demonstrate enhanced task reliability and streamlined navigational efficiency, highlighting the advantages over static-reward methods and offering a scalable solution for complex and multi-task robotic endovascular procedures.