Complex robotic compared to manual coronary interventions: 6‐ and 12‐month outcomes

Abstract

Objectives To assess the long‐term safety and efficacy of robotic percutaneous coronary revascularization for use in complex coronary lesions. Background Robotically assisted percutaneous coronary intervention (PCI) is safe and feasible in simple coronary lesions and has excellent short‐term procedural and clinical outcomes for complex lesions; however, long‐term safety and efficacy outcomes are unknown. Methods A total of 103 consecutive patients underwent a total of 108 robotic (R)‐PCI procedures (age 68.1; 78.3% male) over 18 months, and 210 patients underwent a total of 226 manual (M)‐PCI procedures (age 67.5; 78.1% male) during the same period. Patients were subsequently followed and both 6‐month and 12‐month major adverse cardiovascular events (MACE), comprised of any death, stroke, myocardial infarction, or target vessel revascularization, are reported and compared. Results There was no difference between the two groups with regard to overall MACE at 6 months (R‐PCI 5.8% vs. M‐PCI 3.3%, P = 0.51) or at 12 months (R‐PCI 7.8% vs. M‐PCI 8.1%, P = 0.92). There was no difference between the individual components of the primary combined endpoint at either time point. No access site complications occurred in either cohort that met BARC III or higher criteria. Conclusions At the 6‐ and 12‐month time points following R‐PCI, no difference in clinical outcomes or safety measures was observed as compared to M‐PCI.

Safety and feasibility of robotic assisted percutaneous coronary intervention compared to standard percutaneous coronary intervention- a systematic review and meta-analysis

“…Although this study did not compare long term outcomes of R–PCI and S–PCI there is no reason to believe that major adverse cardiovascular events (MACE) rates would be different at 1 year. Prior work by Walters et al 21 reported no difference in MACE in a study of 333 patients at 6 months and 12 months follow up.…”

Robotics, imaging, and artificial intelligence in the catheterisation laboratory

“…The system also allowed use of phased-array IVUS, laser atherectomy 64 , and other devices. Comparison of 6-and 12-month outcomes between robotic and manual PCI in complex lesions 65 showed equivalence between procedures 66 . Geographical miss was markedly reduced by robotic assistance 67 .…”

Safety and Feasibility of Intravascular Ultrasound-Guided Robotic

“…Moreover, our de nition of LGM via IVUS analysis was objective and may be more reliable. Another study comparing MACE between robotic and manual PCI (M-PCI) at 6 months and 1 year in more complex lesions found no difference between both groups [4]. While the foreminded study had a mean lesion length of 22.2 mm and a 79% prevalence of typeB2/C cases, which is close to that observed in real-world populations, their MACE at 1 year was 7.8% and 8.1% in the R-PCI and M-PCI groups, which indicated no signi cant difference.…”

“…Robot-assisted percutaneous coronary intervention (R-PCI), an innovative technological development introduced in 2005 [1], can reduce surgeon exposure to radiation given that it allows for treatment from a distance [2] and has been utilized for chronic total occlusions and more complex lesions [3] [4]. Although several reports have highlighted the bene ts of R-PCI for surgeons, only a few have focused on its advantages for patients [5] [6].…”