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Initial report of safety and procedure duration of robotic‐assisted chronic total occlusion coronary intervention
Author(s) -
Hirai Taishi,
Kearney Kathleen,
Kataruka Akash,
Gosch Kensey L.,
Brandt Hunter,
Nicholson William J.,
Lombardi William L.,
Grantham J. Aaron,
Salisbury Adam C.
Publication year - 2020
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28477
Subject(s) - medicine , conventional pci , cockpit , lead apron , myocardial infarction , perforation , percutaneous coronary intervention , surgery , stroke (engine) , cardiology , fluoroscopy , aeronautics , mechanical engineering , punching , materials science , engineering , metallurgy
Background No previous reports have examined the impact of robotic‐assisted (RA) chronic total occlusion (CTO) PCI on procedural duration or safety compared to totally manual CTO PCI. Methods Among 95 patients who underwent successful PCI of a single CTO lesion at two centers, 49 (52%) were performed RA and were performed 46 (48%) totally manually. Cockpit time was the time the primary operator entered to robotic cockpit until the procedure was complete. “Theoretical” cockpit time in the control group was time the primary operator would have entered the cockpit after lesion crossing until the procedure was complete. Major adverse events (MAEs) were the composite of death, myocardial infarction, clinical perforation, significant vessel dissection, arrhythmia, acute thrombosis, and stroke. Results The lesion characteristics, procedural time, and contrast dose were similar. All procedures except for one (2%) selected for robotic completion after lesion crossing were completed successfully. The frequency of MAE was similar between groups and there were no in‐hospital deaths. The cockpit time was 8 min longer in RA CTO PCI than the theoretical cockpit time in totally manual CTO PCI (40.6 ± 12.7 vs. 32.1 ± 17.8, p < .01). Conclusion RA CTO PCI was not associated with excess adverse events compared with totally manual CTO PCI and resulted in an average 41 min cockpit time equaling to 48% of procedure time without radiation exposure or requirement for the primary operator to wear a lead apron. Understanding the relationship between cockpit time and reductions in radiation exposure and lead apron‐related orthopedic complications for operators requires future study.