Tufts University School of Medicine, Boston, USA.
J Cardiovasc Transl Res. 2012 Feb;5(1):62-6. doi: 10.1007/s12265-011-9324-9. Epub 2011 Nov 9.
Percutaneous coronary intervention (PCI) has undergone a remarkable evolution over the past 25 years. Initially, the procedure was limited to relatively straightforward lesions and was associated with significant risk and unpredictable long-term efficacy. With the incorporation of new technologies such as stents, the safety and efficacy of the procedure has improved dramatically. However, the fundamental way in which the procedure is performed has changed little since the time of Gruntzig's first successful case. Cumulative exposure to ionizing radiation, orthopedic injuries resulting from wearing shielding aprons, and fatigue from standing for hours at the table have made the catheterization laboratory a "high-risk workplace" for the interventional cardiologist. Robotic-assisted PCI was developed to allow the operator to precisely manipulate angioplasty guidewires, balloons, and stents from a radiation-shielded cockpit. A small first-in-man study demonstrated that PCI can be performed with robotic assistance. The pivotal Percutaneous Robotically Enhanced Coronary Intervention Study trial is currently enrolling patients and evaluating the safety and efficacy of the CorPath® robotically assisted PCI system.
经皮冠状动脉介入治疗(PCI)在过去 25 年中经历了显著的发展。最初,该手术仅限于相对简单的病变,并且存在显著的风险和不可预测的长期疗效。随着支架等新技术的引入,该手术的安全性和疗效有了显著提高。然而,自从 Gruntzig 首例成功病例以来,手术的基本操作方式几乎没有改变。由于累积暴露于电离辐射、穿戴屏蔽围裙导致的骨科损伤以及在手术台上长时间站立的疲劳,导管室已成为介入心脏病专家的“高风险工作场所”。机器人辅助 PCI 的开发是为了让操作者能够从辐射屏蔽驾驶舱中精确地操作血管成形术导丝、球囊和支架。一项小型的首例人体研究表明,PCI 可以通过机器人辅助完成。目前正在招募患者并评估 CorPath®机器人辅助 PCI 系统的安全性和疗效的关键 Percutaneous Robotically enhanced Coronary Intervention 研究试验。