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Haptic devices enable communication via touch, augmenting visual and auditory displays, or by offering alternative channels of communication when vision and hearing are unavailable. Because of the different types of haptic stimuli that are perceivable by users — vibration, skin stretch, pressure and temperature, among others — devices can be designed to communicate complex information by delivering multiple types of haptic stimuli simultaneously. These multi-sensory haptic devices are often designed to be wearable and have been developed for use in a wide variety of applications, including communication, entertainment and rehabilitation. Multi-sensory haptic devices present unique challenges to designers because human perceptual acuity can vary widely depending on the wearable location on the body and/or the heterogeneity in human perceptual performance, particularly when multiple cues are presented simultaneously. Additionally, packaging haptic systems in a wearable form factor presents its own engineering challenges such as cue masking, device mounting and actuator capabilities, among others. Thus, in this Review, we discuss the state-of-the-art and specific obstacles present in the field to produce multi-sensory devices that enhance the human capacity for haptic interaction and information transmission. 

Haptic feedback offers a useful mode of communication in visually or auditorily noisy environments. The adoption of haptic devices in our everyday lives, however, remains limited, motivating research on haptic wearables constructed from materials that enable comfortable and lightweight form factors. Textiles, a material class fitting these needs and already ubiquitous in clothing, have begun to be used in haptics, but reliance on arrays of electromechanical controllers detracts from the benefits that textiles offer. Here, we mitigate the requirement for bulky hardware by developing a class of wearable haptic textiles capable of delivering high-resolution information on the basis of embedded fluidic programming. The designs of these haptic textiles enable tailorable amplitudinal, spatial, and temporal control. Combining these capabilities, we demonstrate wearables that deliver spatiotemporal cues in four directions with an average user accuracy of 87%. Subsequent demonstrations of washability, repairability, and utility for navigational tasks exemplify the capabilities of our approach. 

Purpose: Robotic-assisted carotid artery stenting (CAS) cases have been demonstrated with promising results. However, no quantitative measurements have been made to compare manual with robotic-assisted CAS. This study aims to quantify surgical performance using tool tip kinematic data and metrics of precision during CAS with manual and robotic control in an ex vivo model. Materials and Methods: Transfemoral CAS cases were performed in a high-fidelity endovascular simulator. Participants completed cases with manual and robotic techniques in 2 different carotid anatomies in random order. C-arm angulations, table position, and endovascular devices were standardized. Endovascular tool tip kinematic data were extracted. We calculated the spectral arc length (SPARC), average velocity, and idle time during navigation in the common carotid artery and lesion crossing. Procedural time, fluoroscopy time, movements of the deployed filter wire, precision of stent, and balloon positioning were recorded. Data were analyzed and compared between the 2 modalities. Results: Ten participants performed 40 CAS cases with a procedural success of 100% and 0% residual stenosis. The median procedural time was significantly higher during the robotic-assisted cases (seconds, median [interquartile range, IQR]: 128 [49.5] and 161.5 [62.5], p=0.02). Fluoroscopy time differed significantly between manual and robotic-assisted procedures (seconds, median [IQR]: 81.5 [32] and 98.5 [39.5], p=0.1). Movement of the deployed filter wire did not show significant difference between manual and robotic interventions (mm, median [IQR]: 13 [10.5] and 12.5 [11], p=0.5). The postdilation balloon exceeded the margin of the stent with a median of 2 [1] mm in both groups. Navigation with robotic assistance showed significantly lower SPARC values (–5.78±3.14 and –8.63±3.98, p=0.04) and higher idle time values (8.92±8.71 and 3.47±3.9, p=0.02) than those performed manually. Conclusions: Robotic-assisted and manual CAS cases are comparable in the precision of stent and balloon positioning. Navigation in the carotid artery is associated with smoother motion and higher idle time values. These findings highlight the accuracy and the motion stabilizing capability of the endovascular robotic system. Clinical Impact Robotic assistance in the treatment of peripheral vascular disease is an emerging field and may be a tool for radiation protection and the geographic distribution of endovascular interventions in the future. This preclinical study compares the characteristics of manual and robotic-assisted carotid stenting (CAS). Our results highlight, that robotic-assisted CAS is associated with precise navigation and device positioning, and smoother navigation compared to manual CAS.