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SCAI: Robots Can Do PCI -- They Just Take Longer

— Is this the dawn of a new age for the cath lab?

MedpageToday

ORLANDO -- Robots can successfully perform percutaneous coronary intervention (PCI) in both simple and complex coronary lesions, the CORA-PCI study suggested.

Technical success during PCI with the CorPath robot, which remotely controls coronary guidewires and stents, reached 91.7% with a single operator. Additionally, more than 90% of patients receiving robotically-assisted PCI did so with minimal manual assistance, according to, of University of California San Diego School of Medicine, and colleagues.

Action Points

  • Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

Rates of clinical success were similar between robot- and human-conducted PCI (99.1% versus 99.6%, P=0.64), they reported at the Society for Cardiovascular Angiography and Interventions (SCAI) meeting.

What's more, there was no uptick in radiation exposure (fluoroscopy time 18.2 minutes versus 19.2 minutes, P=0.42) or stent deployment (1.59 stents versus 1.54 stents, P=0.58) in the robot-assisted cohort.

Even so, procedures took longer in this group: 44 minutes 30 seconds versus 36 minutes 34 seconds for recipients of manual PCI (P=0.005), and neither multivariable adjustment nor propensity score matching eliminated that disadvantage.

"For the first time, we've shown nearly identical outcomes with a group of very complex patients," Mahmud nevertheless told SCAI attendees. He also suggested that the data show that robotics can be a viable alternative to manual PCI.

The CORA-PCI analysis included 315 patients for a total of 334 PCI procedures over 18 months. Patients undergoing atherectomies and two-stent strategies for bifurcation lesions were excluded, as were those with chronic total occlusions.

Approximately 80% of lesions treated were complex, according to Mahmud's group.

  • author['full_name']

    Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine.

Disclosures

Mahmud disclosed a relevant relationships with Corindus.

Primary Source

Society for Cardiovascular Angiography and Interventions

Mahmud E, et al "Demonstration of the safety and feasibility of robotically assisted percutaneous coronary intervention in complex coronary lesions: results of the complex robotically assisted percutaneous coronary intervention (CORA-PCI) trial" SCAI 2016; Abstract 148087.