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One solution for improving timely access to mechanical thrombectomy in geographically diverse populations is the widespread deployment of robotic surgical systems. Artificial intelligence assistance may enable the safe and effective upskilling of operators in this emerging therapeutic delivery approach. Our aim was to establish consensus frameworks for developing and validating artificial intelligence\u2013assisted robots for thrombectomy. Objectives included standardizing effectiveness metrics and defining reference testbeds across in silico, in\u00a0vitro, ex\u00a0vivo, and in\u00a0vivo environments. To achieve this, we convened experts in neurointervention, robotics, data science, health economics, policy, statistics, and patient advocacy. Consensus was built through an incubator day, a Delphi process, and a final position statement. We identified that the 4 essential testbed environments each had distinct validation roles. Realism requirements vary: simpler testbeds should include realistic vessel anatomy compatible with guidewire and catheter use, whereas standard testbeds should incorporate deformable vessels. More advanced testbeds should include blood flow, pulsatility, and disease features, such as atheromatous plaques. There are 2 macroclasses of effectiveness metrics: one for in silico, in\u00a0vitro, and ex\u00a0vivo stages focusing on technical navigation (eg, path\u2010following error), and another for in\u00a0vivo stages, focused on clinical outcomes (eg, modified treatment in cerebral infarction scores). Patient safety is central, and not a barrier, to this technology's development. One requisite patient safety task needed now is to correlate in\u00a0vitro measurements to in\u00a0vivo complications.<\/jats:p>","DOI":"10.1161\/jaha.125.044931","type":"journal-article","created":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T13:09:38Z","timestamp":1774703378000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["A Position Statement on Endovascular Models and Effectiveness Metrics for Mechanical Thrombectomy Navigation, on Behalf of the Stakeholder Taskforce for Artificial Intelligence\u2013Assisted Robotic Thrombectomy (START)"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5486-8062","authenticated-orcid":false,"given":"Harry","family":"Robertshaw","sequence":"first","affiliation":[{"name":"Kings College London","place":["London, 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