Complication during robotic-PCI: Iatrogenic guiding catheter dissection

Area of Science:

• Cardiovascular Interventions
• Medical Robotics
• Interventional Cardiology

Background:

• Robotic-assisted percutaneous interventions (R-PCI) utilize advanced platforms like the CorPath GRX for enhanced procedural control.
• The CorPath GRX system enables joystick-based manipulation of guiding catheters, aiming to improve operator safety and precision in cardiovascular procedures.

Observation:

• A rare but severe complication occurred during an R-PCI procedure involving the CorPath GRX system.
• The complication manifested as a dramatic left main stem dissection, directly linked to the manipulation of the guiding catheter via robotic controls.

Findings:

• Robotic guide catheter manipulation, while intended for precision, can lead to catastrophic complications such as left main stem dissection.
• This case underscores the potential for unforeseen risks associated with novel robotic technologies in interventional cardiology.

Implications:

• Careful technique and heightened awareness are critical when employing robotic systems for percutaneous interventions.
• Further research and training are necessary to mitigate risks and optimize the safety profile of R-PCI technologies.
• Understanding and addressing such complications are vital for the safe integration of robotics in interventional cardiology.