Department of Medicine, St George's University of London, London, UK.
School of Medicine, University of Liverpool, Liverpool, UK.
J Cardiol. 2022 Dec;80(6):495-504. doi: 10.1016/j.jjcc.2022.02.002. Epub 2022 Feb 12.
Robotic percutaneous coronary intervention (R-PCI) is a promising medical procedure being used in clinical settings, which is thought to produce superior clinical and technical outcomes compared to the traditional manual approach. We performed a systematic review and meta-analysis to compare R-PCI to manual PCI (M-PCI).
A systematic literature search was performed using Pubmed, Medline (Ovid), Google Scholar, SCOPUS, and Embase from inception until the end of August 2021. Keywords used were ''Robotic PCI'' and ''Robotic angioplasty.'' Twenty studies were included for the qualitative analysis and seven for the pooled meta-analyses.
There was no significant difference between R-PCI and M-PCI groups in terms of clinical success (risk ratio: 1.01, 95% CI: 0.99-1.02, p=0.45) and procedure time (mean difference: 4.55, 95% CI: 0.08-9.02, p=0.05). Both contrast volume (mean difference: -15.27, 95% CI: -22.37 - -8.18, p<0.0001) and fluoroscopy time (mean difference: -1.26, 95% CI: -2.37 - -0.16, p=0.03) were significantly lower in the R-PCI group. Technical success rates in all studies were equal to or greater than 70% (mean: 93.1, SD: 7.8), with four studies reporting 100% success rates.
Given the comparable clinical short-term safety of R-PCI to that of M-PCI and the high technical success rates across several large, high-quality cohort studies, the clinician can be reassured about the ability of robotic devices. However, randomized long-term data are warranted before making prospective conclusions on the clinical and technical merits of R-PCI and adopting it as part of standard coronary interventions.
机器人经皮冠状动脉介入治疗（R-PCI）是一种有前途的医学治疗方法，已在临床环境中使用，被认为比传统的手动方法产生更好的临床和技术效果。我们进行了一项系统评价和荟萃分析，以比较 R-PCI 与手动 PCI（M-PCI）。
使用 Pubmed、Medline（Ovid）、Google Scholar、SCOPUS 和 Embase 从建库到 2021 年 8 月底进行系统文献检索。使用的关键词是“机器人 PCI”和“机器人血管成形术”。对 20 项研究进行定性分析，对 7 项研究进行汇总荟萃分析。
在临床成功率（风险比：1.01，95%置信区间：0.99-1.02，p=0.45）和手术时间（平均差异：4.55，95%置信区间：0.08-9.02，p=0.05）方面，R-PCI 组与 M-PCI 组之间无显著差异。在 R-PCI 组中，造影剂用量（平均差异：-15.27，95%置信区间：-22.37 - -8.18，p<0.0001）和透视时间（平均差异：-1.26，95%置信区间：-2.37 - -0.16，p=0.03）均显著降低。所有研究的技术成功率均等于或大于 70%（平均值：93.1，标准差：7.8），其中 4 项研究报告的成功率为 100%。
鉴于 R-PCI 与 M-PCI 的短期临床安全性相当，并且多项大型高质量队列研究的技术成功率较高，临床医生可以对机器人设备的能力感到放心。然而，在得出关于 R-PCI 的临床和技术优点并将其作为标准冠状动脉介入治疗的一部分的前瞻性结论之前，需要有随机的长期数据。
