Safety and feasibility during early implementation of robotic-assisted percutaneous coronary intervention

TL;DR

This study evaluates the safety and outcomes of robotic-assisted heart procedures during early implementation at a hospital in Vietnam.

Contribution

The study provides early clinical evidence on robotic-assisted PCI implementation in a new setting, highlighting success rates and complications.

Findings

Robotic success was achieved in 94.6% of lesions during early R-PCI implementation.

No major adverse cardiovascular events occurred during hospitalization.

One stroke-related death occurred during six-month follow-up, emphasizing the need for long-term studies.

Abstract

Robotic-assisted Percutaneous Coronary Intervention (R-PCI) is an advanced technique offering potential advantages for both patients and interventional cardiology practices. In 2023, Can Tho S.I.S General Hospital implemented its first robotic system for PCI procedures. This study aimed to evaluate the safety and clinical outcomes during the early learning curve of R-PCI.

This prospective study included all patients undergoing R-PCI with the CorPath GRX Vascular Robotic System at Can Tho S.I.S General Hospital from April to September 2023. Baseline patient characteristics, procedural details, and six-month follow-up data were collected. Primary outcomes included Clinical Success, defined as <30% residual diameter stenosis in the target vessel without major adverse cardiovascular events (MACE) during hospitalization (e.g., death, myocardial infarction, target-vessel revascularization, stroke), and robotic success, defined as achieving clinical success with partial manual support or no manual support.

Thirty-one patients (mean age 64.5 ± 10 years; 64.5% male) with 37 lesions underwent R-PCI. Robotic success was achieved in 94.6% (35/37 lesions), comprising 21 lesions (56.8%) performed as full R-PCI and 14 lesions (37.8%) requiring partial manual support (exclusively for IVUS catheter manipulation). Manual conversion occurred in 5.4% due to inadequate guiding-catheter back-up and slow-flow. No MACE occurred during hospitalization; however, one patient died from a stroke during the six-month follow-up.

This study demonstrates high success rates and minimal complications for R-PCI in its early implementation phase. Nevertheless, the stroke-related death observed during follow-up highlights the need for long-term studies to comprehensively assess R-PCI's safety and efficacy.

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