Title : Effectiveness and safety of robot-assisted coronary intervention: Research results from Vietnam
Abstract:
Introduction: Robotic-assisted percutaneous coronary intervention (R-PCI) has shown safety and efficacy, but direct comparisons with manual PCI (M-PCI) are limited.
Objective: To compare the outcomes and safety of R-PCI using the CorPath GRX system versus M-PCI in patients with chronic coronary syndrome and non-ST-elevation myocardial infarction (NSTEMI) during hospitalization.
Subjects and Methods: A prospective cohort study with propensity score matching analyzed 38 R-PCI cases and 76 M-PCI cases at S.I.S Can Tho International General Hospital from March 2023 to May 2024.
Evaluation Criteria: Technical and Clinical Success Rates: Assessing and comparing success rates between R-PCI and M-PCI.
Safety Assessment: Evaluating major adverse cardiac events (MACE), fluoroscopy time, procedure duration, contrast medium volume, patient radiation dose, and radiation exposure to primary and assisting operators.
Results: The mean age was 64.7 ± 10.1 years in the R-PCI group and 66.2 ± 9.0 years in the M-PCI group (p = 0.128). Outcomes between the R-PCI and M-PCI groups were as follows: Technical success rates: 95.5% vs. 100%, p=0.115. Clinical success rates: 92.1% vs. 92.1%, p=0.717. In-hospital MACE: 5.3% vs. 7.9%, p=0.646. Procedural duration: 50min vs. 40min, p=0.072. Total Contrast volume: 175mL vs. 160mL, p=0.475. Fluoroscopy time: 14.4min vs. 12.3min, p=0.04. Dose area product: 6848.6µGym² vs. 5562.3µGym², p=0.046. Radiation exposure to both assisting and primary operators was significantly reduced during R-PCI. Assisting operators received 0.25mSv in 38 R-PCI vs. 0.96mSv in 76 M-PCI and primary operators are 0mSv in 38 R-PCI vs. 1.28mSv in 76 M-PCI cases.
Conclusion: R-PCI achieved technical and clinical success rates comparable to manual PCI, with no significant difference in complications. It significantly reduced radiation exposure to the operator, however fluoroscopy time and dose area product were not decreased during R-PCI.
Keywords: Percutaneous coronary intervention, Robotic-assisted percutaneous coronary intervention (R-PCI), Manual assistance percutaneous coronary intervention, Robotic corindus.
