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Planned Robotic Chronic Total Occlusion Percutaneous Coronary Intervention: Feasibility Report
Daniel Walters, Mitul Patel, Ryan Reeves
1Sulpizio Cardiovascular Center, 9434 Medical Center Drive, La Jolla, CA 92037. emahmud@ucsd.edu.
The Journal of Invasive Cardiology
|April 25, 2020
Summary
Robotic percutaneous coronary intervention (R-PCI) is feasible for chronic total occlusion (CTO) revascularization. Success is more likely in patients with lower J-CTO scores and lesions suitable for antegrade wiring techniques.
Area of Science:
- Cardiovascular Interventions
- Medical Robotics
- Interventional Cardiology
Background:
- Robotic percutaneous coronary intervention (R-PCI) is technically feasible with outcomes comparable to manual approaches.
- Limited data exist on the efficacy of R-PCI for chronic total occlusion (CTO) revascularization.
Purpose of the Study:
- To evaluate the feasibility and outcomes of R-PCI for CTO revascularization.
- To identify predictors of technical success in robotic CTO procedures.
Main Methods:
- Retrospective analysis of 10 consecutive patients undergoing R-PCI for coronary CTO.
- Data collected from PRECISION, PRECISION GRX, and PROGRESS CTO registries.
Main Results:
- Technical success (CTO revascularization with robotic assistance) achieved in 7 of 10 patients.
- No periprocedural major adverse cardiac events occurred.
- Average J-CTO score was 2, with all procedures using an antegrade approach; average procedure and fluoroscopy times were 55.1 and 29.9 minutes, respectively.
Conclusions:
- Robotic CTO revascularization is feasible.
- Low J-CTO scores and antegrade wire escalation suitability predict technical success.
- Further research is warranted due to potential benefits for operators and patients.
