关于机器人辅助经皮冠状动脉介入治疗最新研究进展的叙述性综述。

Narrative review of latest research progress about robotic percutaneous coronary intervention.

作者信息

Liu Zhen-Yu, Zhai Guang-Yao

机构信息

Department of Clinical Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, China.

Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing, China.

出版信息

J Geriatr Cardiol. 2024 Aug 28;21(8):816-825. doi: 10.26599/1671-5411.2024.08.004.

Abstract

Robotic percutaneous coronary intervention (R-PCI) is a novel technology in which operators can manipulate guidewires and catheter devices in interventional cardiology. This approach provides great benefits to interventional cardiologists in terms of reducing both radiation exposure and orthopedic injuries. Several large, high-quality cohort studies have confirmed the short-term safety and high technical success rate of R-PCI. However, randomized long-term data are still needed before adopting them as part of standard coronary interventions. Furthermore, tele-stenting for complex coronary lesions has significant potential for R-PCI. We need to overcome the present relevant challenges for its application such as inherent delays, bedside care for unstable patients from R-PCIs to manual PCIs (M-PCIs), incompatibility for a thrombus aspiration catheter and heavily calcified lesions. There is a great future in laboratory workflow teams, 3D-printed anatomical models and multiple joint collaborative control algorithms. This narrative review summarizes the latest developments in R-PCI, with a focus on developments in robotic technology, and discusses the current and future potential use of R-PCI in clinical practice globally.

摘要

机器人辅助经皮冠状动脉介入治疗(R-PCI)是一种新技术,在介入心脏病学中,操作者可以通过它操控导丝和导管装置。这种方法在减少辐射暴露和骨科损伤方面,为介入心脏病学家带来了极大的益处。几项大型、高质量的队列研究已经证实了R-PCI的短期安全性和高技术成功率。然而,在将其作为标准冠状动脉介入治疗的一部分采用之前,仍需要随机长期数据。此外,对于复杂冠状动脉病变的远程支架植入术,R-PCI具有显著潜力。我们需要克服其应用目前面临的相关挑战,如固有延迟、从R-PCI转换为手动PCI(M-PCI)时对不稳定患者的床边护理、血栓抽吸导管的不兼容性以及严重钙化病变。实验室工作流程团队、3D打印解剖模型和多关节协同控制算法有着广阔的前景。这篇叙述性综述总结了R-PCI的最新进展,重点是机器人技术的发展,并讨论了R-PCI在全球临床实践中的当前和未来潜在应用。

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