From the Apex Heart Institute, Ahmedabad, India (T.M.P., S.C.S., Y.Y.S., R.C.R., P.O.T.).
The Wright Center for Graduate Medical Education, Scranton, PA (G.A.P., S.B.P.).
Circ Cardiovasc Interv. 2020 May;13(5):e008888. doi: 10.1161/CIRCINTERVENTIONS.119.008888. Epub 2020 May 14.
Robotic percutaneous coronary intervention (R-PCI) has been shown to benefit the operator but has not shown any significant benefit to the patient. We sought to compare a large cohort of R-PCI to traditional percutaneous coronary intervention (PCI) procedures performed at a tertiary care center in the same time frame.
A total of 996 consecutive patients referred for PCI between December 2017 and March 2019 were studied, of which 310 (31.1%) patients were selected to undergo R-PCI and 686 (68.9%) patients underwent traditional PCI. The coprimary study outcome measures were air kerma, dose-area product, fluoroscopy time, volume of contrast, and total procedural time. Caliper propensity-matching technique was used (caliper, 0.05) to match each R-PCI patient to the nearest traditional PCI patient without replacement.
Air kerma (mGy; median [interquartile range]; ; 884 [537-1398] versus 1110 [699-1498]; =0.002) and dose-area product (cGycm; 4734 [2695-7746] versus 5746 [3751-7833]; =0.003) were significantly lower in the R-PCI group. There was no difference in fluoroscopy time (minutes; 5.51 [3.53-8.31] versus 5.48 [3.31-9.37]; =0.936) and contrast volume (mL; 130 [103-170] versus 140 [100-180]; =0.905). Total procedural time (minutes) was significantly higher in the R-PCI group (27 [21-40] versus 37 [27-50]; <0.0005).
R-PCI is associated with a significant decrease in radiation exposure to the patient with no increase in fluoroscopy time, as well as contrast utilization, and a minor increase in procedure duration compared with traditional PCI.
机器人经皮冠状动脉介入治疗（R-PCI）已被证明对操作者有益，但对患者没有任何显著益处。我们旨在比较同一时期在三级护理中心进行的大型 R-PCI 队列和传统经皮冠状动脉介入治疗（PCI）手术。
研究纳入了 2017 年 12 月至 2019 年 3 月间因 PCI 而就诊的 996 例连续患者，其中 310 例（31.1%）患者选择接受 R-PCI，686 例（68.9%）患者接受传统 PCI。主要研究终点是空气比释动能、剂量-面积乘积、透视时间、造影剂用量和总手术时间。采用卡尺倾向评分匹配技术（卡尺，0.05）对每个 R-PCI 患者进行无替换的最近传统 PCI 患者匹配。
R-PCI 组的空气比释动能（mGy；中位数[四分位间距]；；884 [537-1398] 与 1110 [699-1498]；=0.002）和剂量-面积乘积（cGycm；4734 [2695-7746] 与 5746 [3751-7833]；=0.003）明显更低。透视时间（分钟；5.51 [3.53-8.31] 与 5.48 [3.31-9.37]；=0.936）和造影剂用量（mL；130 [103-170] 与 140 [100-180]；=0.905）无差异。R-PCI 组的总手术时间（分钟）明显更长（27 [21-40] 与 37 [27-50]；<0.0005）。
与传统 PCI 相比，R-PCI 可显著降低患者的辐射暴露，而透视时间、造影剂使用和手术时间仅有轻微增加。
