title: Percutaneous coronary intervention using a combination of robotics and telecommunications by an operator in a separate physical location from the patient: an early exploration into the feasibility of telestenting (the REMOTE-PCI study).
abstract: OBJECTIVE
  The present study explores the feasibility of telestenting, wherein a physician operator performs stenting on a patient in a separate physical location using a combination of robotics and telecommunications.
  
  
  RESULTS
  Patients undergoing robotic stenting were eligible for inclusion. All manipulations of guidewires, balloons, and stents were performed robotically by a physician operator located in an isolated separate room outside the procedure room housing the patient. Communication between the operating physician and laboratory personnel was via telecommunication devices providing real-time audio and video connectivity. Among 20 patients who consented to participate, technical success, defined as successful advancement and retraction of guidewires, balloons, and stents by the robotic system without conversion to manual operation, was achieved in 19 of 22 lesions (86.4%). Procedural success, defined as <30% residual stenosis upon completion of the procedure in the absence of death or repeat revascularisation prior to hospital discharge, was achieved in 19 of 20 patients (95.0%). There were no deaths or repeat revascularisations prior to hospital discharge.
  
  
  CONCLUSIONS
  To the best of our knowledge, the present study is the first to explore the feasibility of telestenting. Additional studies are required to determine if future advancements in robotics will facilitate telestenting over greater geographic distances.
authors.affiliation: Frederik Meijer Heart & Vascular Institute, Spectrum Health, Grand Rapids, MI, USA.
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Madder
authors.forename: Stacie M
authors.initials: SM
authors.lastname: VanOosterhout
authors.forename: Mark E
authors.initials: ME
authors.lastname: Jacoby
authors.forename: J Stewart
authors.initials: JS
authors.lastname: Collins
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Borgman
authors.forename: Abbey N
authors.initials: AN
authors.lastname: Mulder
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Elmore
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Campbell
authors.forename: Richard F
authors.initials: RF
authors.lastname: McNamara
authors.forename: David H
authors.initials: DH
authors.lastname: Wohns
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods; D012371:Robotics; D015607:Stents; D013685:Telecommunications; D016896:Treatment Outcome