Procedural and Clinical Outcomes of Second-generation Robotic-assisted versus Manual Percutaneous Coronary...

Robotic-assisted percutaneous coronary intervention (rPCI) offers potential benefits, including improved lesion assessment, optimised stent deployment and reduced radiation exposure. However, comparative data, particularly in Japanese populations, remain limited.

To compare procedural and clinical outcomes between second-generation rPCI and manual percutaneous coronary intervention (mPCI) in patients with chronic coronary syndrome and acute coronary syndrome over a 1-year follow-up period.

This retrospective cohort study included 176 patients who underwent rPCI using the second-generation CorPath GRX Vascular Robotic System. Following 1:1 propensity score matching at the lesion level, 176 patients were identified in the mPCI group. The co-primary endpoints were 1-year all-cause mortality and major adverse cardiovascular events, defined as a composite of cardiac death, non-fatal MI, target lesion revascularisation, stent thrombosis and stroke.

Both groups had similar baseline characteristics. Compared with mPCI, rPCI was associated with shorter total procedural time (26 minutes [19-37] versus 71 minutes [52-90]; p<0.01), fluoroscopy time (14 minutes [10-18] versus 16 minutes [10-26]; p=0.04), lower contrast volume (99 [82.8-129.0] versus 141 ml [116-172]; p<0.01) and lower dose area product (3,628.3 [2,552.1-5,352.3] versus 6,349.1 [4,080.0-8,382.3]; p<0.01). At 1 year, the co-primary endpoints of all-cause mortality (p=0.33) and major adverse cardiovascular events (p=0.79) were comparable between groups.

Compared with mPCI, rPCI was associated with shorter procedural and fluoroscopy times, lower contrast volume and lower dose area product, while demonstrating similar clinical outcomes at 1 year.