This work has been submitted to the IEEE for possible publication. Abstract--In endovascular surgery, endovascular intervention-ists push a thin tube called a catheter, guided by a thin wire to a treatment site inside the patient's blood vessels to treat various conditions such as blood clots, aneurysms, and malformations. Guidewires with robotic tips can enhance maneuverability, but they present challenges in modeling and control. Automation of soft robotic guidewire navigation has the potential to overcome these challenges, increasing the precision and safety of endovascular navigation. In other surgical domains, end-to-end imitation learning has shown promising results. Thus, we develop a transformer-based imitation learning framework with goal conditioning, relative action outputs, and automatic contrast dye injections to enable generalizable soft robotic guidewire navigation in an aneurysm targeting task. We train the model on 36 different modular bifurcated geometries, generating 647 total demonstrations under simulated fluoroscopy, and evaluate it on three previously unseen vascular geometries. The model can autonomously drive the tip of the robot to the aneurysm location with a success rate of 83% on the unseen geometries, outperforming several baselines. In addition, we present ablation and baseline studies to evaluate the effectiveness of each design and data collection choice. IAGNOSIS and treatment of vascular conditions require an endovascular interventionist to skillfully advance catheters and guidewires through the patient's blood vessels.

Autonomous robots in endovascular interventions possess the potential to navigate guidewires with safety and reliability, while reducing human error and shortening surgical time. However, current methods of guidewire navigation based on Reinforcement Learning (RL) depend on manual demonstration data or magnetic guidance. In this work, we propose an Image-guided Autonomous Guidewire Navigation (IAGN) method. Specifically, we introduce BDA-star, a path planning algorithm with boundary distance constraints, for the trajectory planning of guidewire navigation. We established an IAGN-RL environment where the observations are real-time guidewire feeding images highlighting the position of the guidewire tip and the planned path. We proposed a reward function based on the distances from both the guidewire tip to the planned path and the target to evaluate the agent's actions. Furthermore, in policy network, we employ a pre-trained convolutional neural network to extract features, mitigating stability issues and slow convergence rates associated with direct learning from raw pixels. Experiments conducted on the aortic simulation IAGN platform demonstrated that the proposed method, targeting the left subclavian artery and the brachiocephalic artery, achieved a 100% guidewire navigation success rate, along with reduced movement and retraction distances and trajectories tend to the center of the vessels.