Evaluating Patients' Profiles and Procedural Outcomes of Robotically Assisted Percutaneous Coronary Interventions: A...

Background/Objectives: Robotic-assisted percutaneous coronary intervention (R-PCI) reduces occupational hazards, may enhance procedural precision and has demonstrated comparable efficacy to manually performed PCI (M-PCI). However, the switch from M-PCI to R-PCI represents a unique challenge and learning curve, which remains undefined. The purpose of this study was to evaluate patients' profile and procedural outcomes over time after starting an R-PCI programme at a tertiary cardiac centre. Methods: All consecutive patients who underwent R-PCI with the second-generation CorPath GRX R-PCI system at our centre between March 2021 and January 2024 were included. The study cohort was divided into two equal groups representing the early and late experience. Clinical profile, lesion characteristics and procedural outcomes were compared between both groups. Angiographic success was defined as TIMI 3 flow and less than 30% stenosis, and R-PCI technical success as angiographic success without any unplanned manual input. Results: For 102 patients (mean age 68 years, 73% male) who underwent R-PCI, the angiographic success rate was 100%, and the R-PCI technical success rate was 83.33%, with 16.67% of patients requiring unplanned manual input. In the late (n = 51) versus early (n = 51) group, more bifurcations (52.94% vs. 33.33%, p = 0.046) and ACC/AHA (American College of Cardiology/American Heart Association) type C lesions (45.10% vs. 25.49%, p = 0.038) were treated with no significant differences in contrast volume, radiation dose, procedural time or peri-procedural complications between the two groups. Conclusions: R-PCI appears feasible with acceptable short-term results. In our experience, after ~50 cases, increasing complexity of lesions can be treated without significantly impacting procedural outcomes or safety.