Robotic percutaneous coronary intervention (R-PCI): Time to focus on the pros and cons

Thirumurugan, E; Gomathi, K; Swathy, P; Afrin, Syed Ali; Karthick, R

doi:10.1016/j.ihj.2023.04.002

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…The slow adoption of RA-PCI systems in Switzerland and worldwide despite consistently reported favorable safety and reduction in radiation exposure to the operator may be related to the additional costs ( 23 ) not covered by the healthcare systems, need for highly qualified tableside assistants, lack of clinical benefit and limitation in use of more specialized PCI equipment. The possibility of long-distance remote PCI (“tele-stenting”), which has already been performed in India ( 24 ), is unlikely to become relevant in Switzerland given the high density of catheterization laboratories, but may be an interesting opportunity for large countries ( 25 ). Nevertheless, the slow adoption resulted in the recent retraction of the robotic CorPath GRX system by the manufacturer due to economic considerations although competitive products continue to be commercialized.…”

Section: Discussionmentioning

confidence: 99%

Robotic-assisted percutaneous coronary intervention: experience in Switzerland

Häner,

Räber,

Moro

et al. 2023

Front. Cardiovasc. Med.

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Aims of the studyPercutaneous 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.MethodsAll 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.ResultsTwenty-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.ConclusionsRA-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.

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Section: Discussionmentioning

confidence: 99%

Robotic-assisted percutaneous coronary intervention: experience in Switzerland

Häner,

Räber,

Moro

et al. 2023

Front. Cardiovasc. Med.

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Shockwave Intravascular Lithotripsy: The Future of Coronary Intervention?

Thirumurugan,

Gomathi,

Karthick

2023

Research in Cardiovascular Medicine

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Aim: The objective is to evaluate the safety, efficiency, and clinical outcomes of Intravascular Lithotripsy Systems for treating Calcified Coronary Artery Disease (CAC) during revascularization. Methods: Intravascular Lithotripsy (IVL) in India remains largely unexplored. Unfortunately, there is an alarming lack of sufficient data on this innovative technique, with only a handful of articles on IVL available in non-indexed journals that are not easily accessible online. This review aims to serve as a valuable source of information and promote further research on this innovative technique. Results/Conclusion: Intravascular lithotripsy systems have significantly impacted interventional cardiology, greatly improving the efficiency and safety of procedures. Coronary intravascular lithotripsy shows great promise in treating Calcified Coronary Artery Disease (CAC) during revascularization. IVL can be safely performed before stent implantation, with a high rate of procedural success and a low incidence of complications.

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Robotic percutaneous coronary intervention (R-PCI): Time to focus on the pros and cons

Cited by 2 publications

References 29 publications

Robotic-assisted percutaneous coronary intervention: experience in Switzerland

Robotic-assisted percutaneous coronary intervention: experience in Switzerland

Shockwave Intravascular Lithotripsy: The Future of Coronary Intervention?

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