Robotically-assisted percutaneous coronary intervention: Reasons for partial manual assistance or manual conversion

Area of Science:

• Cardiology
• Medical Technology
• Interventional Cardiology

Background:

• Robotically-assisted percutaneous coronary intervention (R-PCI) has shown feasibility for treating simple coronary artery lesions.
• The CorPath 200 System allows remote control of intracoronary devices from a radiation-shielded cockpit.

Purpose of the Study:

• To evaluate the frequency and reasons for manual assistance or conversion during R-PCI in a real-world clinical setting.
• To identify factors contributing to deviations from full robotic control in R-PCI procedures.

Main Methods:

• Analysis of 108 consecutive R-PCI procedures performed over 18 months.
• Categorization of manual assistance/conversion reasons into adverse events, robotic technical limitations, or guide catheter/wire support issues.

Main Results:

• High robotic technical success (91.7%) and clinical procedural success (99.1%) were achieved in 108 R-PCI procedures.
• 18.5% of procedures required some form of manual assistance or conversion.
• The primary reasons for manual intervention were limited guide catheter/wire support (45%) and robotic platform limitations (40%), with adverse events accounting for 15%.

Conclusions:

• R-PCI can achieve high clinical success even in a complex lesion cohort.
• Occasional manual assistance or conversion is necessary, primarily due to system or support limitations rather than safety concerns.