Radiation-Free Percutaneous Coronary Intervention: Myth or Reality?

Area of Science:

• Interventional Cardiology
• Medical Technology
• Occupational Health

Background:

• Radiation exposure is a significant occupational hazard in cardiac catheterization labs, leading to health issues for staff.
• Increasing procedural complexity necessitates enhanced safety and precision in percutaneous coronary intervention (PCI).
• Robotic-assisted PCI (R-PCI) offers a solution to minimize radiation and improve operator ergonomics.

Purpose of the Study:

• To review current clinical evidence and technological advancements in radiation reduction for PCI.
• To focus on the role of R-PCI, procedural modifications, and shielding technologies.
• To explore the integration of advanced imaging like CT-based angiography and AI in minimizing radiation exposure.

Main Methods:

• Systematic review of clinical trials, registries, and experimental studies.
• Evaluation of robotic PCI platforms, radiation dose metrics, and ergonomic factors.
• Analysis of integrated imaging (CCTA, FFR-CT) and low-dose protocols.

Main Results:

• R-PCI shows high technical (81-100%) and clinical (up to 100%) success rates.
• Significant reductions in operator radiation exposure (up to 95%) and ergonomic burden.
• Advanced shielding and integrated imaging further minimize radiation, though device compatibility and haptic feedback remain challenges.

Conclusions:

• R-PCI, coupled with shielding and imaging, represents a paradigm shift towards safer, radiation-minimizing interventional cardiology.
• This evolution redefines safety, precision, and sustainability in modern interventional procedures.
• The integration of technology addresses critical occupational hazards and enhances procedural outcomes.