Robotic-assisted Percutaneous Coronary Intervention Research Articles

Regulatory Review of Robotic-Assisted Percutaneous Coronary Intervention in Japan.

The CorPath GRX system (Corindus) was approved in 2018, enabling the first robotic-assisted percutaneous coronary intervention (PCI) in Japan. The approval was based on the results of clinical studies from other countries conducted with the first-generation CorPath 200 system (Corindus). Considering no proven use of a remote control device for PCI in Japan, confirming the efficacy and safety of the CorPath GRX system in Japanese real-world clinical practice through a use-results survey was deemed necessary. One condition for approval was that necessary measures should be taken to ensure that the product is used by appropriate operators and facilities. These measures included the dissemination of guidelines for proper use developed in conjunction with related academic societies and the implementation of training courses. The survey results confirmed that the CorPath GRX system is effective and safe. However, some characteristics of the implementation procedure differed from those reported in clinical studies from other countries. This review demonstrates that collecting real-world data is useful for understanding product safety and efficacy, and for identifying issues for future product improvement.

One-year outcome of robotical vs. manual percutaneous coronary intervention.

Robotic-assisted percutaneous coronary intervention (R-PCI) is a promising technology for optimizing the treatment of patients with coronary heart disease. For a better understanding of the potential of R-PCI in clinical routine compared to conventional manual PCI (M-PCI) both initial treatment success of the index procedure and long-term outcome have to be analysed. Prospective evaluation from the FRiK (DRKS00023868) registry of all R-PCI cases with the CorPath GRX Cardiology by Siemens Healthineers and Corindus in the Freiburg University Heart Center between 04/2022 and 03/2023. Index procedure success and safety, radiation dose of patients and personnel, and 1-year outcome will be reported. Findings will be compared to a prospective control group of M-PCI patients treated by the same team of interventionalists during the same observation period. Seventy patients received R-PCI and were included in the registry. PCI success rate was 100%, with 19% requiring manual assistance. No complications (MACE-major adverse cardiovascular events) occurred. Compared with 70 matched-pair M-PCI patients, there was a higher median procedural time (103min vs. 67min, p < 0.001) and fluoroscopy time (18min vs. 15min, p = 0.002), and more contrast volume was used (180 ml vs. 160ml, p = 0.041) in R-PCI vs. M-PCI patients. However, there was no significant difference of the dose-area product (4062 vs. 3242 cGycm2, p = 0.361). One year after the intervention, there was no difference in mortality, rehospitalisation, unscheduled PCI or target vessel failure. Health-related quality of life evaluation 6 and 12months after the index procedure (NYHA, CCS, SAQ7 and EQ-5D-5L) was similar in both groups. R-PCI is feasible and safe. Compared to M-PCI, index procedure success rate is high, safety profile is favourable, and manual assistance was required in only few cases. At 1-year follow-up results for R-PCI vs. M-PCI considering mortality, rehospitalisation, morbidity and target vessel failure were equal.

Long-distance Tele-robotic-assisted Percutaneous Coronary Intervention: A Case Report of First-in-patient in China

Robotic-assisted percutaneous coronary intervention (R-PCI) is an innovative way of performing percutaneous coronary intervention (PCI) whereby the operator can manipulate coronary intraluminal guidewires and catheter devices by using remotely controlled technology. Performing tele-R-PCI from a remote location via fifth generation network communication technology has never been reported in China; however, if this were possible, the technique could be used to treat many patients with coronary artery disease who would otherwise not have the opportunity of treatment. The case of a 73-year-old male patient with coronary artery disease who underwent successful tele-R-PCI at 800 km from the operators is presented. Performing long-distance tele-R-PCI in patients with coronary artery disease is feasible with predictably successful outcomes when reliable network connectivity and local cardiac catheterization facilities are present.

Establishing a Robotic-Assisted Percutaneous Coronary Intervention (R-PCI) Program: Initial Australian Experience

Establishing a Robotic-Assisted Percutaneous Coronary Intervention (R-PCI) Program: Initial Australian Experience

Advancements in artificial intelligence-driven techniques for interventional cardiology.

This paper aims to thoroughly discuss the impact of artificial intelligence (AI) on clinical practice in interventional cardiology (IC) with special recognition of its most recent advancements. Thus, recent years have been exceptionally abundant in advancements in computational tools, including the development of AI. The application of AI development is currently in its early stages, nevertheless new technologies have proven to be a promising concept, particularly considering IC showing great impact on patient safety, risk stratification and outcomes during the whole therapeutic process. The primary goal is to achieve the integration of multiple cardiac imaging modalities, establish online decision support systems and platforms based on augmented and/or virtual realities, and finally to create automatic medical systems, providing electronic health data on patients. In a simplified way, two main areas of AI utilization in IC may be distinguished, namely, virtual and physical. Consequently, numerous studies have provided data regarding AI utilization in terms of automated interpretation and analysis from various cardiac modalities, including electrocardiogram, echocardiography, angiography, cardiac magnetic resonance imaging, and computed tomography as well as data collected during robotic-assisted percutaneous coronary intervention procedures. Thus, this paper aims to thoroughly discuss the impact of AI on clinical practice in IC with special recognition of its most recent advancements.

Robotic Assisted Percutaneous Coronary Intervention: Initial Australian Experience

Robotic-assisted percutaneous coronary intervention (R-PCI) has been increasingly performed overseas. Initial observations have demonstrated its clinical efficacy and safety with additional potential benefits of more accurate lesion assessment and stent deployment, with reduced radiation exposure to operators and patients. However, data from randomised controlled trials or clinical experience from Australia are lacking. This was a single-centre experience of all patients undergoing R-PCI as part of the run-in phase for an upcoming randomised clinical trial (ACTRN12623000480684). All R-PCI procedures were performed using the CorPath GRX robot (Corindus Vascular Robotics, Waltham, Massachusetts, USA). Key inclusion criteria included patients with obstructive coronary disease requiring percutaneous coronary intervention. Major exclusion criteria included ST-elevation myocardial infarction, cardiogenic shock or lesions deemed unsuitable for R-PCI by the operator. Clinical success was defined as residual stenosis <30% without in-hospital major adverse cardiovascular events (MACE). Technical success was defined as the completion of the R-PCI procedure without unplanned manual conversion. Procedural characteristics were compared between early (cases 1-3) and later (cases 4-21) cases. Twenty-one (21) patients with a total of 24 lesions were analysed. The mean age of patients was 66.5 years, and 66% of cases were male. Radial access was used in 18 cases (86%). Most lesions were American Heart Association/American College of Cardiology class B2/C (66%). Clinical success was achieved in 100% with manual conversion required in four cases (19%). No procedural complications or in-hospital MACE occurred. Compared to the early cases, later cases had a statistically significantly shorter fluoroscopy time (44.0mins vs 25.2mins, p<0.007), dose area product (967.3 dGy.cm2 vs 361.0dGy.cm2, p=0.01) and air kerma (2484.3mGy vs 797.4mGy, p=0.009) with no difference in contrast usage (136.7mL vs 131.4mL, p=0.88). We present the first clinical experience of R-PCI in Australia using the Corindus CorPath GRX robot. We achieved clinical success in all patients and technical success in the majority of cases with no procedural complications or in-hospital MACE. With increasing operator and staff experience, cases required shorter fluoroscopy time and less radiation exposure but similar contrast usage.

Procedural and one-year outcomes of robotic-assisted versus manual percutaneous coronary intervention.

Robotic-assisted percutaneous coronary intervention (rPCI) has proven to be feasible and safe. Comparative analyses of rPCI versus manual PCI (mPCI) are scarce. We aimed to investigate procedural aspects and outcomes of rPCI using the second-generation CorPath GRX Vascular Robotic System compared with mPCI in patients with chronic coronary syndrome and non-ST-segment elevation myocardial infarction acute coronary syndrome. From January to April 2021, 70 patients underwent rPCI at the University Heart & Vascular Center Hamburg-Eppendorf and were recruited into the INTERCATH study. By propensity score matching, a control cohort of 210 patients who underwent mPCI from 2015-2021 was identified. Co-primary endpoints were one-year all-cause mortality and major adverse cardiovascular events (MACE) as a composite of cardiovascular death, unplanned target lesion revascularisation, myocardial infarction, and stroke. The median age of the patients (n=280) was 70.7 (25th percentile-75th percentile: 62.0-78.0) years, and 24.6% were female. The Gensini score (28.5 [16.2-48.1] vs 28.0 [15.5-47.0]; p=0.78) was comparable between rPCI versus mPCI. During the PCI procedure, total contrast fluid volume did not differ, whilst longer fluoroscopy times (20.4 min [13.8-27.2] vs 14.4 min [10.4-24.3]; p=0.001) were documented in the rPCI versus mPCI cohort. After 12 months of follow-up, neither all-cause mortality (p=0.22) nor MACE (p=0.25) differed between the groups. rPCI was associated with longer fluoroscopy times compared with mPCI, though without increased use of contrast medium. One-year follow-up revealed no differences in all-cause mortality or MACE, supporting the safety of a robotic-assisted approach.

Robotic-assisted percutaneous coronary intervention: the future or the past?

Robotic-assisted percutaneous coronary intervention: the future or the past?

Long-term clinical outcomes of robotic-assisted surgical coronary artery revascularisation.

Patients who are not candidates for traditional coronary artery bypass grafting (CABG) and amenable only for percutaneous coronary intervention (PCI) with stents can receive the "gold standard" left internal thoracic artery (LITA) to left anterior descending artery (LAD) anastomosis through robotic-assisted CABG and PCI to non-LAD coronary targets. We aimed to analyse clinical outcomes of robotic-assisted CABG. A total of 2,280 consecutive patients who had undergone robotic-assisted CABG between May 2005 and June 2021 were included in our study. Robotic-assisted LITA harvest was followed by LITA-LAD manual anastomosis through a 4 cm left thoracotomy. Hybrid coronary intervention (HCR) consists of stent implantation in a non-LAD coronary artery performed within 7 days after robotic-assisted LITA-LAD. We performed a propensity-adjusted analysis comparison after dividing all robotic-assisted CABG patients into three time periods: 2005-2010, 615 patients; 2011-2016, 904 patients; and 2017-2021, 761 patients. The mean age increased from 64.5 years in the first time period to 65.8 years in the second time period to 68.1 years in the third (p<0.0001). Operative time was progressively reduced in the three periods (6.4; 6.2; 5.5 hours; p<0.001). The incidence of conversion to sternotomy remained similar for each period (1.8%; 1.7%; 1.5%; p=0.53). Thirty-day mortality in the three periods included 9 (1.4%), 9 (1.0%), and 7 (0.9%) patients, respectively (p=0.91), while 8 (0.3%) patients had PCI with stents in the entire group. The mean follow-up for the entire population was 4.2 years. At follow-up, the rates of all-cause death, major adverse cardiac and cerebrovascular events, non-fatal stroke, and repeat revascularisation with stents were significantly decreased from the first to the last period (pË0.0001). Robotic-assisted CABG and HCR provides good long-term outcomes in patients who are not candidates for conventional CABG.

Latest Developments in Robotic Percutaneous Coronary Interventions

Since the first robotic-assisted percutaneous coronary intervention procedure (R-PCI) was performed in 2004, there has been a steady evolution in robotic technology, combined with a growth in the number of robotic installations worldwide and operator experience. This review summarises the latest developments in R-PCI with a focus on developments in robotic technology, procedural complexity, tele-stenting and training methods, which have all contributed to the global expansion in R-PCI.

Robotic-assisted percutaneous coronary intervention: experience in Switzerland.

Percutaneous coronary intervention (PCI) exposes operators to ionizing radiation. Robotic-assisted PCI (RA-PCI) is a novel technology that enables interventional cardiologists to operate coronary devices remotely from a radiation-shed cockpit. The aim of this study is to describe the experience and challenges during the initiation of a RA-PCI program and to report outcomes of the first 21 patients undergoing RA-PCI in Switzerland. All patients undergoing RA-PCI using the CorPath GRX Vascular Robotic System between 06/2021 and 12/2021 at Inselspital, Bern University Hospital were included in this retrospective registry study. Baseline, procedural and clinical follow-up data were prospectively assessed as part of the Cardiobase Bern PCI registry (NCT02241291). The two endpoints of interest were clinical success [defined as <30% residual diameter stenosis in the absence of in-hospital major adverse cardiovascular events (MACE: composite of death, periprocedural myocardial infarction, target-vessel revascularization, and stroke)] and robotic success (defined as clinical success and completion of RA-PCI without or with partial manual assistance). Additional outcome measures include clinical long-term outcomes at one year. Twenty-five lesions in 21 patients were treated with RA-PCI (age 62.4 ± 9.1 years, 24% female). Clinical success was achieved in 100%, and robotic success in 81% (17/21 procedures, including 4 procedures requiring partial manual assistance). Manual conversion (e.g. manual completion of the procedure) occurred in 19% (4 procedures). Reasons for manual assistance or conversion were poor guiding-catheter back-up or platform limitations (4), adverse events (2x transient slow-flow that was solved manually), safety decision (1x vasovagal reaction not related to robotic approach), and software error (1). No in-hospital MACE occurred. During 12 months of follow-up, one patient suffered a non-target-vessel myocardial infarction requiring repeat PCI. RA-PCI can safely be performed without clinically relevant robot-associated complications in selected patients with approximately 80% of procedures conducted without or with partial manual assistance.

A multi-device robotic-assisted PCI system: a proof-of concept study for left main bifurcation stenting with culotte technique in a porcine model

Background and purpose: Robotic-assisted percutaneous coronary intervention (PCI) has been increasingly used for simple lesion. For complex lesions, extensive manual intervention is still required. This study aims to verify the stability and safety of this robot system in complex lesion under fifth-generation (5G) network before clinical trial. Methods: We developed a robotic system that allows simultaneous remote control of multiple devices using a 5G wireless network. The key feature of the system is a bionic thumb along with two-bionic forefingers. The system was tested in eight pigs (six over 18.3 km and two over 1,100 km). Two stents were placed in the left main bifurcation using the culotte technique. All procedures, barring device loading onto the robot system, including manipulation of the guiding catheter, wire adjustments, stent or balloon positioning, and notably the final kissing step, were conducted remotely. Results: The rate of procedure success was 100%, with no device-related complications. In comparison to short-distance remote control, the delay with long-distance remote control was minimal (90.9 ± 1.5 vs. 81.5 ± 2.7 ms for command data transmission; 163.2 ± 1.3 vs. 161.0 ± 1.4 ms for image transmission). The procedure time was shorter when using two pairs versus a single pair of bionic fingers (104.3 ± 10.2 vs. 126.0 ± 3.9 min), primarily due to less time needed for device loading and exchange (33.1 ± 4.2 vs. 56.1 ± 4.0 min). Conclusions: With the 5G network, long distance was not a significant barrier for robotic-assisted PCI for chronic total occlusion. A design of the independent bionic finger module enabled final kissing balloon inflation with reduced requirement for manual intervention. Whether the system could be used beyond left main bifurcation lesions requires further investigation.

Robotic Control of a 0.035-Inch Guidewire: Initial Feasibility and First-in-Human Experience.

Robotic procedures represent a new frontier for interventional cardiology. 1 Beyar R. Davies J.E. Cook C. Dudek D. Cummins P.A. Bruining N. Robotics, imaging, and artificial intelligence in the catheterisation laboratory. EuroIntervention. 2021; 17: 537-549 Crossref PubMed Scopus (3) Google Scholar The latest generation robotic platform is the CorPath GRX System (Corindus Inc, Waltham, MA), which is composed of an interventional cockpit and a single-use cassette incorporated within a robotic arm. The cassette has a dedicated “wire track” to control 0.014-inch or 0.018-inch wires and a dedicated “device track” to advance and retrieve balloons and stents (Fig. 1A). One limitation of the current cassette is the absence of a specific “track” designed for the commonly used 0.035-inch wire. 2 Chakravartti J. Rao S.V. Robotic-assisted percutaneous coronary intervention: hype or hope?. J Am Heart Assoc. 2019; 8: 1-4 Crossref Scopus (14) Google Scholar The possibility of controlling this wire is important, particularly for peripheral endovascular procedures, in which the 0.035-inch wire is commonly used to advance catheters, balloons, and stents.

Evaluation of Performance of Robotic-Assisted Coronary Angioplasty System Over Conventional/Manual PCI

Most percutaneous coronary intervention (PCI) might present hazards for patients, procedure operators, and the laboratory staff [1-3]. Due to complex nature of lesions and procedures, both patients and laboratory team may be subjected to exposure of longer procedural duration and radiation [3]. The long hours of standing for operators while wearing a lead apron commonly leads to exhaustion and injuries that frequently results in reduced performance and sub optimal clinical results [1]. A remote-control, robotic-assisted angioplasty system was developed to address some of the procedural challenges and occupational hazards associated with traditional PCI in addition to enhancing the degree of precision and control for the interventional procedure. A remote- control, robotic-assisted angioplasty system is used to address some of the procedural challenges and occupational hazards associated with traditional PCI. The objective of this study was to assess the safety and feasibility of the operating robotic system in patients undergoing elective PCI. This review summarises the safety and feasibility of a robotic angioplasty system in delivery and manipulation of coronary guidewires, balloons, and stents in patients undergoing PCI. Patients with coronary artery disease and clinical indication for elective PCI were enrolled. The coronary angioplasty procedure was performed with the CorPath 200 robotic system (Corindus, Inc.) The operating system consists of a remote interventional cockpit and a multicomponent bedside unit that contains advance, retract, and rotate guidewires within rapid exchange catheters. The primary endpoint was device clinical success (30% residual stenosis) with- out in-hospital major adverse cardiac events. The procedural success was defined as the ability of the system to complete all the planned angioplasty steps based on procedural segments.30 days follow up after angioplasty procedure was done. A total of 47 patients were enrolled in the study. Primary endpoint had been achieved in all patients. The success of the robotic system was 98.1% in completing 48 of 49 planned steps. No device or procedure-related complications were reported and no in-hospital or 30-day major adverse cardiac events were observed. We rated the robotic system performances as equal to as or better than manual procedures in 97.7% of the cases. Cardiologist’s radiation exposure was 97% lower than found at the standard table position. Our procedure results demonstrated better safety, feasibility and procedural effectiveness than manual operation. Besides, total operator exposure to radiation was quite low. However, a larger study is warranted to confirm the safety and effectiveness of robotic-assisted percutaneous coronary intervention.

Robotic-assisted PCI – insights from a monocenter registry

Abstract Background Robotics in interventional cardiology is a rapidly evolving technique, which is still in an early phase of development and clinical application. Beside the pivotal studies, there is limited real world data on success rates and safety of this new technology. Purpose To investigate the success rate as well as the safety profile of robotic-assisted percutaneous coronary intervention (R-PCI) and compare it with manual PCI (M-PCI). Methods We report preliminary data of our ongoing, prospective FRiK registry, started in mid 2021. This registry focuses on success rates and safety, radiation dose of patients and personnel, long-term outcome (after 6, 12 and 24 months), as well as on economic aspects and the learning curve of the interventionalists. Moreover, the R-PCI is compared with the M-PCI in these categories. Results So far, 51 patients (age 69 (62–80) years, BMI 28.4 (25.2–32) kg/m2, 74.5% male), received R-PCI. PCI success rate was 100%, with 15% requiring manual assistance (Figure 1). Rate of complications (myocardial infarction after PCI, dissection, stent thrombosis, pericardial effusion, target lesion revascularization and MACE (major adverse cardiovascular events) was 0%. Compared with 41 M-PCI patients (Table 1), treated by the same interventionalists, there was a higher median procedural time (diagnostic and intervention) 106 (82–127) min vs. 71 (54–93) min (p&amp;lt;0.001) and fluoroscopy time 20.3 (14.8–28.5) min vs. 14.8 (10.4–22.4) min (p=0.012) in R-PCI patients. However, there was no significant difference between the dose-area product 4662.4 (3019.4–6399.2) cGy cm2 vs. 4193.9 (2759.9–6254.3) cGy cm2 (p=0.487) and contrast volume use 200 (150–280) ml vs. 180 (145–255) ml (p=0.587). Conclusion Preliminary results of R-PCI showed a high success rate, low rates for need of manual assistance, and a very high safety profile without any complications. The dose-area product and contrast volume use were comparable between R-PCI and M-PCI, whereas R-PCI showed a longer procedural and fluoroscopy time. Future steps will include a larger number of cases and definitions of patient cases with optimal eligibility for R-PCI. Funding Acknowledgement Type of funding sources: None.

Safety and Efficacy of Robotic-Assisted PCI.

Robotics has been used in multiple areas of procedural medical intervention. Robotic percutaneous coronary intervention (PCI) has been available since 2004. Its adoption has been slow with initial application in simple cases. With increasing adoption, robotic PCI has been applied to a broader variety of coronary substrates with demonstration of safety and efficacy. Improvements in the robotic console with future generation devices should add to the utility of this platform. Robotic PCI advances the innovations in endovascular space into a different dimension, removing the dependence of the procedure on patient-operator ergonomics and likely operator skill.

Periprocedural and 30-day outcomes of robotic-assisted percutaneous coronary intervention used in the intravascular imaging guidance

In recent years, there have been several reports on robotic-assisted percutaneous coronary intervention (R-PCI), but few studies have been conducted on R-PCI performed under intravascular imaging guidance. To elucidate the periprocedural and postoperative 30-day outcomes of intravascular imaging-guided R-PCI, we performed a retrospective observational study on all patients in 102 consecutive cases who underwent R-PCI under intravascular imaging guidance at a single center in Japan from June 12, 2019 to February 18, 2021. The primary end point was 30-day survival, and the secondary end point was the incidence of complications. Intravascular imaging-guided R-PCI was performed 110 times in total on 125 lesions. The medians of procedural time, fluoroscopy time, contrast volume, patient entrance skin dose, and radiation exposure to the main operator were 49 min, 16 min, 67 mL, 0.62 Gy, and 0 μSv, respectively. Furthermore, 60.0% of target lesion branches were American College of Cardiology Foundation/American Heart Association classification type B2 or type C. However, in all cases, lesion dilatation was successful, and the final Thrombolysis in Myocardial Infarction flow grade was 3. The combination of manual operation was required in 12.7% of all cases, but 30-day survival was confirmed in all cases. There were two problems at the puncture site. One small distal branch artery dissection occurred due to manual operation, but no cardiovascular events (myocardial infarction, stroke) occurred and no target lesion restenosis was observed within 30 days of R-PCI. Hence, R-PCI using intravascular imaging demonstrated highly satisfactory treatment outcomes, and no complication caused by robotic operation was observed.

Robotic Percutaneous Coronary Intervention During COVID-19 Pandemic: Outcomes and Cost Effectiveness With Procedural Distancing.

The COVID-19 pandemic raised many questions, including the need to maintain distancing and the importance of full personal protection equipment (PPE) for healthcare workers. Robotic-assisted percutaneous coronary intervention (R-PCI) can be advantageous during a pandemic to facilitate procedural distancing for cath lab personnel and to decrease the cumulative amount of PPE employed. All patients who underwent R-PCI during the early phase of the pandemic were evaluated at a single institution. Procedural characteristics, complexity of disease, and use of adjunctive imaging or physiology were queried. Mean R-PCI time, procedure and fluoroscopy times, radiation dose, and contrast volume were collected. Cost of PPE incurred with R-PCI was evaluated in comparison with traditional cases. Furthermore, procedural distancing from patients for operators was objectively quantified to compare with traditional cath lab cases. Thirteen patients were treated using R-PCI. Radial access site was utilized in 54% and the left circumflex artery was treated most frequently (in 50% of cases). The complexity of cases performed was illustrated by revascularization of chronic total occlusions in 2 patients (14%) as well as adjunctive intravascular ultrasound or instantaneous wave-free ratio in 4 patients (29%). Mean R-PCI time was 45.38 minutes, manual time was 25.66 minutes, and total procedure time was 71.08 minutes. Average fluoroscopy time was 18.27 minutes, contrast volume was 143.85 mL, and radiation dose was 747.15 mGy. R-PCI was more cost effective, with total average PPE cost of $330.71 in comparison with $496.08 for traditional PCI (absolute difference, $165.36). Furthermore, R-PCI demonstrated substantial procedural distancing of operators from patients (8.14 feet for R-PCI vs 2.75 feet for traditional PCI; absolute difference, 5.39 feet). R-PCI could be a promising strategy during a pandemic by facilitating procedural distancing, minimizing staffing exposure risk, and decreasing PPE cost.

Safety and effectiveness of introducing a robotic-assisted percutaneous coronary intervention program in a tertiary center: a prospective study.

Robotic-assisted percutaneous coronary intervention (PCI) is a novel technology that permits remote operation of interventional devices. However, little is known about the safety and effectiveness of introducing a robotic PCI program in a hospital already experienced in traditional coronary angioplasty. Prospective single-arm survey to assess the safety and effectiveness of robotic-assisted PCI in comparison to pre-defined performance goals. The study cohort comprised all consecutive cases treated with robotic PCI since its introduction. The safety primary endpoint was a composite of (I) overall death or (II) non-fatal adverse events related to target vessel complications (stent thrombosis, myocardial infarction, vessel perforation or cardiac tamponade, or repeat invasive treatment) during the index hospitalization. The efficacy primary endpoint was robotic-assisted procedural success, a composite of (I) successful dilatation of the target lesion and (II) successful robotic assistance, defined as absent non-planned manual conversion. A total of 83 patients and 112 lesions were prospectively enrolled. The rate of angiographic success was 99.1%. From these, 97 lesions (86.6%) were treated with only robotic PCI or with hybrid according to the pre-interventional plan. The rates of efficacy and safety primary endpoints were 85.7% and 2.4% respectively (P<0.01 for non-inferior to the pre-defined performance threshold). Introduction of robotic-assisted PCI in a tertiary center was associated with safe and effective results, comparable to pre-defined goals of optimal performance.

Robotic Percutaneous Coronary Intervention: The Good, the Bad, and What is to Come

The introduction of robots into healthcare has brought a wealth of opportunity for technical advancements, ranging from cleaning robots to disinfect hospital rooms to the high-tech surgical robots used in the operating room. Robotic-assisted percutaneous coronary intervention (R-PCI) has been a more recent development in the field, and is particularly revolutionary in that it serves to benefit the interventional cardiologist as well as the patient. Published data on R-PCI have shown its feasibility, safety, and more recently, its potential benefits. This review examines the current role of the robot in the catheterization laboratory, the authors’ experience with the most current generation of the robot, and what is yet to come.