Background:
Robotic percutaneous coronary intervention (R-PCI) has been shown to benefit the operator but has not shown any significant benefit to the patient. We sought to compare a large cohort of R-PCI to traditional percutaneous coronary intervention (PCI) procedures performed at a tertiary care center in the same time frame.
Methods:
A total of 996 consecutive patients referred for PCI between December 2017 and March 2019 were studied, of which 310 (31.1%) patients were selected to undergo R-PCI and 686 (68.9%) patients underwent traditional PCI. The coprimary study outcome measures were air kerma, dose-area product, fluoroscopy time, volume of contrast, and total procedural time. Caliper propensity-matching technique was used (caliper, 0.05) to match each R-PCI patient to the nearest traditional PCI patient without replacement.
Results:
Air kerma (mGy; median [interquartile range];
P
; 884 [537–1398] versus 1110 [699–1498];
P
=0.002) and dose-area product (cGycm
2
; 4734 [2695–7746] versus 5746 [3751–7833];
P
=0.003) were significantly lower in the R-PCI group. There was no difference in fluoroscopy time (minutes; 5.51 [3.53–8.31] versus 5.48 [3.31–9.37];
P
=0.936) and contrast volume (mL; 130 [103–170] versus 140 [100–180];
P
=0.905). Total procedural time (minutes) was significantly higher in the R-PCI group (27 [21–40] versus 37 [27–50];
P
<0.0005).
Conclusions:
R-PCI is associated with a significant decrease in radiation exposure to the patient with no increase in fluoroscopy time, as well as contrast utilization, and a minor increase in procedure duration compared with traditional PCI.
Pulmonary arteriovenous fistulae (PAVF) are defined as the abnormal connections between pulmonary arterial and venous circulation bypassing the capillary bed [1]. PAVF might be a part of Osler-Weber-Rendu syndrome or can occur as an isolated anomaly [2]. The presentations of PAVF can range from asymptomatic abnormal shadow in the chest X-ray to the right to left shunt leading to cyanosis [3]. This shunt might result in hypoxemia manifesting with dyspnea, as well as paradoxical embolization, which can cause serious neurologic complications [3].
Case reportOur patient was a 16-year-old boy who presented with clubbing and cyanosis since five years of age. He did not have cyanosis since birth. There was neither history of recurrent lower respiratory tract, nor any history suggestive of congestive heart failure in the childhood. There was no feature of telengiectasia in the skin or mucous membrane. Clinical examination showed central cyanosis, pan-digital clubbing with SpO 2 of 84% in room
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