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与传统手动方法相比的机器人辅助经皮冠状动脉介入治疗

Robotic-Enhanced PCI Compared to the Traditional Manual Approach.

作者信息

Smilowitz Nathaniel R, Moses Jeffrey W, Sosa Fernando A, Lerman Benjamin, Qureshi Yasir, Dalton Kate E, Privitera Lauren T, Canone-Weber Diane, Singh Varinder, Leon Martin B, Weisz Giora

机构信息

Columbia University Medical Center, Shaare Zedek Medical Center, 12 Beyth Street, Jerusalem 91031, Israel.

出版信息

J Invasive Cardiol. 2014 Jul;26(7):318-21.

Abstract

Remote-controlled robotic-enhanced percutaneous coronary intervention (PCI) was developed to improve procedural outcomes, reduce operator radiation exposure, and improve ergonomics. Critics questioned whether protection of the operator might result in increased radiation exposure to the patient and increase contrast media use. We studied this in a single-center comparison of robotic-enhanced versus traditional PCIs. A total of 40 patients who enrolled in the PRECISE study and had PCI with the CorPath 200 robotic system (Corindus Vascular Robotics) were compared to 80 consecutive patients who underwent conventional PCI. All patients had obstructive coronary artery disease, evidence of myocardial ischemia, and clinical indications for single-vessel PCI. Baseline demographics of the 40 robotic and 80 traditional PCIs were similar. Only 2 robotic-assisted cases required conversion to manual PCI. All patients had a final residual stenosis <30%. Robotic-enhanced PCI was associated with trends toward lower duration of fluoroscopy (10.1 ± 4.7 min vs 12.3 ± 7.6 min; P=.05), radiation dose (1389 ± 599 mGy vs 1665 ± 1026 mGy; P=.07), and contrast volume (121 ± 47 mL vs 137 ± 62 mL; P=.11). In conclusion, the initial experience with robotic-enhanced PCI was not associated with increased fluoroscopy duration, radiation, or contrast media exposure to patients, and compared favorably to the traditional approach.

摘要

遥控机器人增强经皮冠状动脉介入治疗(PCI)的研发旨在改善手术效果、减少术者辐射暴露并提高人体工程学性能。批评者质疑对术者的保护是否会导致患者辐射暴露增加以及造影剂使用量增加。我们在一项单中心研究中对机器人增强PCI与传统PCI进行了比较。将40例纳入PRECISE研究并使用CorPath 200机器人系统(Corindus Vascular Robotics)进行PCI的患者与80例连续接受传统PCI的患者进行了比较。所有患者均患有阻塞性冠状动脉疾病、心肌缺血证据且具有单支血管PCI的临床指征。40例机器人辅助PCI和80例传统PCI的基线人口统计学特征相似。仅2例机器人辅助病例需要转为手动PCI。所有患者最终残余狭窄均<30%。机器人增强PCI在透视时间(10.1±4.7分钟对12.3±7.6分钟;P = 0.05)、辐射剂量(1389±599毫戈瑞对1665±1026毫戈瑞;P = 0.07)和造影剂用量(121±47毫升对137±62毫升;P = 0.11)方面有降低趋势。总之,机器人增强PCI的初步经验并未导致患者透视时间、辐射或造影剂暴露增加,且与传统方法相比具有优势。

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