title: Robotic-Enhanced PCI Compared to the Traditional Manual Approach.
abstract: Remote-controlled robotic-enhanced percutaneous coronary intervention (PCI) was developed to improve procedural outcomes, reduce operator radiation exposure, and improve ergonomics. Critics questioned whether protection of the operator might result in increased radiation exposure to the patient and increase contrast media use. We studied this in a single-center comparison of robotic-enhanced versus traditional PCIs. A total of 40 patients who enrolled in the PRECISE study and had PCI with the CorPath 200 robotic system (Corindus Vascular Robotics) were compared to 80 consecutive patients who underwent conventional PCI. All patients had obstructive coronary artery disease, evidence of myocardial ischemia, and clinical indications for single-vessel PCI. Baseline demographics of the 40 robotic and 80 traditional PCIs were similar. Only 2 robotic-assisted cases required conversion to manual PCI. All patients had a final residual stenosis <30%. Robotic-enhanced PCI was associated with trends toward lower duration of fluoroscopy (10.1 ± 4.7 min vs 12.3 ± 7.6 min; P=.05), radiation dose (1389 ± 599 mGy vs 1665 ± 1026 mGy; P=.07), and contrast volume (121 ± 47 mL vs 137 ± 62 mL; P=.11). In conclusion, the initial experience with robotic-enhanced PCI was not associated with increased fluoroscopy duration, radiation, or contrast media exposure to patients, and compared favorably to the traditional approach.
authors.affiliation: Columbia University Medical Center, Shaare Zedek Medical Center, 12 Beyth Street, Jerusalem 91031, Israel. weiszg@szmc.org.il.
authors.forename: Nathaniel R
authors.initials: NR
authors.lastname: Smilowitz
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Moses
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Sosa
authors.forename: Benjamin
authors.initials: B
authors.lastname: Lerman
authors.forename: Yasir
authors.initials: Y
authors.lastname: Qureshi
authors.forename: Kate E
authors.initials: KE
authors.lastname: Dalton
authors.forename: Lauren T
authors.initials: LT
authors.lastname: Privitera
authors.forename: Diane
authors.initials: D
authors.lastname: Canone-Weber
authors.forename: Varinder
authors.initials: V
authors.lastname: Singh
authors.forename: Martin B
authors.initials: MB
authors.lastname: Leon
authors.forename: Giora
authors.initials: G
authors.lastname: Weisz
mesh_terms: D000368:Aged; D000792:Angiography / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000628:therapy*; D004781:Environmental Exposure; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D016272:Occupational Health; D061214:Patient Safety; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D011829:Radiation Dosage; D012042:Registries; D012371:Robotics / Q000379:methods*; D013997:Time Factors
chemical_list: D003287:Contrast Media