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使用AVIAR 2.0系统进行机器人辅助经皮冠状动脉介入治疗的安全性和可行性:一项前瞻性、多中心、单臂、开放性、研究者发起的上市后临床试验。

Safety and Feasibility of Robot-Assisted Percutaneous Coronary Intervention Using the AVIAR 2.0 System: A Prospective, Multi-Center, Single-Arm, Open, Investigator-Initiated, Post-Approval Clinical Trial.

作者信息

Lee Junghoon, Kim Tae Oh, Lee Pil Hyung, Kim Young-Hak, Kwon Osung, Lee Seung-Whan

机构信息

Department of Cardiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Korean Circ J. 2025 Apr;55(4):325-335. doi: 10.4070/kcj.2024.0226. Epub 2024 Nov 5.

Abstract

BACKGROUND AND OBJECTIVES

Traditional manual percutaneous coronary intervention (PCI) exposes operators to significant radiation and physical stress. The recently developed Advanced Vascular Intervention Assist Robot (AVIAR) 2.0 system in South Korea aimed to overcome these issues by evaluating its safety and feasibility in a clinical setting.

METHODS

The study enrolled patients with stable angina from 2 medical centers. Single-vessel de novo lesions were treated using the AVIAR 2.0 system. The primary endpoints were technical success (using the AVIAR system for PCI devices, including guidewires, balloon catheters, and stents, without switching to manual) and clinical success (<30% residual stenosis in the treated lesion and no major cardiovascular events within 48 hours or before discharge). Secondary endpoints included operator radiation exposure and procedural time. Safety was assessed using treatment-emergent adverse events.

RESULTS

Twenty patients (mean age, 63.9±8.5 years, 70% male) underwent robot-assisted PCI for lesions mainly in the left anterior descending artery and right coronary artery, with 95% (19/20) classified as B2/C lesions. The average robotic procedural time was 23:06±05:55 minutes. Technical success was 100%, with no need for manual conversion. Clinical success was 100%, with no major complications until discharge. Operator effective radiation dose was reduced by 84% compared to table effective doses.

CONCLUSIONS

The AVIAR 2.0 system appears to be a safe and effective adjunct to manual PCI, enhancing procedural efficiency and reducing operator radiation exposure. These findings support the use of robotics in coronary interventions and suggest a promising future for minimally invasive cardiac procedures.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT05981859.

摘要

背景与目的

传统的手动经皮冠状动脉介入治疗(PCI)使操作者面临大量辐射和身体压力。韩国最近研发的先进血管介入辅助机器人(AVIAR)2.0系统旨在通过在临床环境中评估其安全性和可行性来克服这些问题。

方法

该研究纳入了来自2个医疗中心的稳定型心绞痛患者。使用AVIAR 2.0系统治疗单支新发病变。主要终点为技术成功(使用AVIAR系统进行PCI操作,包括导丝、球囊导管和支架,无需转为手动操作)和临床成功(治疗病变残余狭窄<30%,且48小时内或出院前无重大心血管事件)。次要终点包括操作者辐射暴露和手术时间。通过治疗中出现的不良事件评估安全性。

结果

20例患者(平均年龄63.9±8.5岁,70%为男性)接受了机器人辅助PCI,病变主要位于左前降支和右冠状动脉,95%(19/20)为B2/C级病变。机器人平均手术时间为23:06±05:55分钟。技术成功率为100%,无需手动转换。临床成功率为100%,出院前无重大并发症。与手术台有效剂量相比,操作者有效辐射剂量降低了84%。

结论

AVIAR 2.0系统似乎是手动PCI的一种安全有效的辅助手段,可提高手术效率并减少操作者辐射暴露。这些发现支持在冠状动脉介入治疗中使用机器人技术,并预示着微创心脏手术的前景广阔。

试验注册

ClinicalTrials.gov标识符:NCT05981859。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dab2/12046302/428df385db46/kcj-55-325-g001.jpg

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