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心导管实验室机器人:介入心脏病学的范式转变?

Cath Lab Robotics: Paradigm Change in Interventional Cardiology?

机构信息

Division of Cardiology, Duke University Medical Center, Durham, NC, USA.

Duke Clinical Research Institute, Durham, NC, USA.

出版信息

Curr Cardiol Rep. 2019 Aug 31;21(10):119. doi: 10.1007/s11886-019-1218-5.

Abstract

PURPOSE OF REVIEW

To review the contemporary evidence for robotic-assisted percutaneous coronary and vascular interventions, discussing its current capabilities, limitations, and potential future applications.

RECENT FINDINGS

Robotic-assisted cardiovascular interventions significantly reduce radiation exposure and orthopedic strains for interventionalists, while maintaining high rates of device and clinical success. The PRECISE and CORA-PCI studies demonstrated the safety and efficacy of robotic-assisted percutaneous coronary intervention (PCI) in increasingly complex coronary lesions. The RAPID study demonstrated similar findings in peripheral vascular interventions (PVI). Subsequent studies have demonstrated the safety and efficacy of second-generation devices, with automations mimicking manual PCI techniques. While innovations such as telestenting continue to bring excitement to the field, major limitations remain-particularly the lack of randomized trials comparing robotic-assisted PCI with manual PCI. Robotic technology has successfully been applied to multiple cardiovascular procedures. There are limited data to evaluate outcomes with robotic-assisted PCI and other robotic-assisted cardiovascular procedures, but existing data show some promise of improving the precision of PCI while decreasing occupational hazards associated with radiation exposure.

摘要

目的综述

回顾机器人辅助经皮冠状动脉和血管介入的当代证据,讨论其当前的能力、局限性和潜在的未来应用。

最近的发现

机器人辅助心血管介入显著降低了介入医生的辐射暴露和骨科压力,同时保持了高设备和临床成功率。PRECISE 和 CORA-PCI 研究证明了机器人辅助经皮冠状动脉介入(PCI)在日益复杂的冠状动脉病变中的安全性和有效性。RAPID 研究在外周血管介入(PVI)中也得出了类似的结果。随后的研究证明了第二代设备的安全性和有效性,自动化技术模拟了手动 PCI 技术。虽然诸如远程支架置入术等创新继续为该领域带来兴奋,但仍存在重大限制——特别是缺乏比较机器人辅助 PCI 与手动 PCI 的随机试验。机器人技术已成功应用于多种心血管程序。目前评估机器人辅助 PCI 和其他机器人辅助心血管程序的结果的数据有限,但现有数据显示,在降低与辐射暴露相关的职业危害的同时,提高 PCI 精度具有一定的前景。

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