# Artificial Intelligence in the Autonomous Navigation of Endovascular Interventions: A Systematic Review

arXiv: https://arxiv.org/abs/2405.03305 · HTML: https://mlsanity.com/paper/2405.03305/

## Key facts

- Cited by 7 papers in the map (data through 14 Oct 2026).
- Builds on 15 of its 82 references that are in the map.
- First posted on arXiv 6 May 2024.

## Builds on (most cited first, 15 of 15)

- [Proximal Policy Optimization Algorithms](https://mlsanity.com/paper/1707.06347/) (2017)
- [ImageNet Large Scale Visual Recognition Challenge](https://mlsanity.com/paper/1409.0575/) (2014)
- [You Only Look Once: Unified, Real-Time Object Detection](https://mlsanity.com/paper/1506.02640/) (2015)
- [Continuous control with deep reinforcement learning](https://mlsanity.com/paper/1509.02971/) (2015)
- [Playing Atari with Deep Reinforcement Learning](https://mlsanity.com/paper/1312.5602/) (2013)
- [Asynchronous Methods for Deep Reinforcement Learning](https://mlsanity.com/paper/1602.01783/) (2016)
- [Generative Adversarial Imitation Learning](https://mlsanity.com/paper/1606.03476/) (2016)
- [Hindsight Experience Replay](https://mlsanity.com/paper/1707.01495/) (2017)
- [Rainbow: Combining Improvements in Deep Reinforcement Learning](https://mlsanity.com/paper/1710.02298/) (2017)
- [Dueling Network Architectures for Deep Reinforcement Learning](https://mlsanity.com/paper/1511.06581/) (2015)
- [An Introduction to Convolutional Neural Networks](https://mlsanity.com/paper/1511.08458/) (2015)
- [A Brief Survey of Deep Reinforcement Learning](https://mlsanity.com/paper/1708.05866/) (2017)
- [Exploring the Limitations of Behavior Cloning for Autonomous Driving](https://mlsanity.com/paper/1904.08980/) (2019)
- [Overcoming Exploration in Reinforcement Learning with Demonstrations](https://mlsanity.com/paper/1709.10089/) (2017)
- [Deep reinforcement learning for guidewire navigation in coronary artery phantom](https://mlsanity.com/paper/2110.01840/) (2021)

## Built on by (most cited first, 7 of 7)

- [Autonomous navigation of catheters and guidewires in mechanical thrombectomy using inverse reinforcement learning](https://mlsanity.com/paper/2406.12499/) (2024)
- [Reinforcement Learning for Safe Autonomous Two Device Navigation of Cerebral Vessels in Mechanical Thrombectomy](https://mlsanity.com/paper/2503.24140/) (2025)
- [World Model for AI Autonomous Navigation in Mechanical Thrombectomy](https://mlsanity.com/paper/2509.25518/) (2025)
- [Advancing Embodied Intelligence in Robotic-Assisted Endovascular Procedures: A Systematic Review of AI Solutions](https://mlsanity.com/paper/2504.15327/) (2025)
- [Toward AI Autonomous Navigation for Mechanical Thrombectomy using Hierarchical Modular Multi-agent Reinforcement Learning (HM-MARL)](https://mlsanity.com/paper/2602.18663/) (2026)
- [Towards Real-Time Autonomous Navigation: Transformer-Based Catheter Tip Tracking in Fluoroscopy](https://mlsanity.com/paper/2605.14253/) (2026)
- [Autonomous Robotic Navigation for Endovascular Brain-Computer Interface Access](https://mlsanity.com/paper/2610.03537/) (2026)

## Abstract (arXiv)

Purpose: Autonomous navigation of devices in endovascular interventions can decrease operation times, improve decision-making during surgery, and reduce operator radiation exposure while increasing access to treatment. This systematic review explores recent literature to assess the impact, challenges, and opportunities artificial intelligence (AI) has for the autonomous endovascular intervention navigation. Methods: PubMed and IEEEXplore databases were queried. Eligibility criteria included studies investigating the use of AI in enabling the autonomous navigation of catheters/guidewires in endovascular interventions. Following PRISMA, articles were assessed using QUADAS-2. PROSPERO: CRD42023392259. Results: Among 462 studies, fourteen met inclusion criteria. Reinforcement learning (9/14, 64%) and learning from demonstration (7/14, 50%) were used as data-driven models for autonomous navigation. Studies predominantly utilised physical phantoms (10/14, 71%) and in silico (4/14, 29%) models. Experiments within or around the blood vessels of the heart were reported by the majority of studies (10/14, 71%), while simple non-anatomical vessel platforms were used in three studies (3/14, 21%), and the porcine liver venous system in one study. We observed that risk of bias and poor generalisability were present across studies. No procedures were performed on patients in any of the studies reviewed. Studies lacked patient selection criteria, reference standards, and reproducibility, resulting in low clinical evidence levels. Conclusions: AI's potential in autonomous endovascular navigation is promising, but in an experimental proof-of-concept stage, with a technology readiness level of 3. We highlight that reference standards with well-identified performance metrics are crucial to allow for comparisons of data-driven algorithms proposed in the years to come.