Łajczak Paweł, Ayesha Ayesha, Sahin Oguz Kagan, Freeman Priscilla Isabel, Majeed Mir Wajid, Righetto Bruno Branco, Obi Ogechukwu, Moreno Gabriel Jacob, Krishna Mrinal Murali, Mulenga Kangwa Francis, Finnegan Emma Ann, Joseph Meghna, Łajczak Anna, Schincariol Michele
Medical University of Silesia, Katowice, Poland.
Shifa College of Medicine, Islamabad, Pakistan.
Cardiovasc Interv Ther. 2025 May 30. doi: 10.1007/s12928-025-01131-8.
Robotic-assistance in the percutaneous coronary intervention procedures (R-PCI) has emerged as a novel alternative to manual PCI (M-PCI). However, previous reviews have not incorporated advancements in new devices. Therefore, we aim to present updated results for a comprehensive systematic review and meta-analysis comparing these two modalities.We systematically searched five databases. Clinical studies comparing R-PCI to M-PCI were included. Continuous outcomes were analyzed using a mean difference (MD), while binary outcomes were assessed with odds ratios (ORs) using random-effect models due to anticipated heterogeneity. A total of 10 papers were included. Clinical success for < 20% residual stenosis was higher (OR 7.93 (95% CI 1.02 to 61.68)), while air kerma was lower (MD - 468.61 (95% CI - 718.32 to - 218.90)) in R-PCI procedures. However, procedural time (MD 5.57 (95% CI - 5.69 to 16.84)), fluoroscopy time (MD - 0.30 (95% CI - 2.26 to 1.66)), contrast dose (MD - 6.29 (95% CI - 25.23 to 12.65)), dose area product (MD - 642.57 (95% CI - 2434.20 to 1149.07)), MACE events (OR 0.54 (95% CI 0.15 to 1.96)), and mortality (OR 1.86 (95% CI 0.82 to 4.22)) showed no significant difference between interventions. TSA showed true positive result. Our meta-analysis reveals decreased air kerma in robotic versus manual PCI but fewer statistically significant outcomes overall. Results from this study offer a more comprehensive view of existing evidence compared to previous analyses.
经皮冠状动脉介入治疗程序中的机器人辅助（R-PCI）已成为手动PCI（M-PCI）的一种新型替代方法。然而，以往的综述并未纳入新设备的进展情况。因此，我们旨在展示一项全面系统评价和荟萃分析的最新结果，以比较这两种方式。我们系统检索了五个数据库。纳入了比较R-PCI与M-PCI的临床研究。由于预期存在异质性，连续结局采用平均差（MD）进行分析，二分类结局采用随机效应模型的比值比（OR）进行评估。共纳入10篇论文。在R-PCI手术中，残余狭窄<20%时的临床成功率更高（OR 7.93（95%CI 1.02至61.68）），而空气比释动能更低（MD -468.61（95%CI -718.32至-218.90））。然而，手术时间（MD 5.57（95%CI -5.69至16.84））、透视时间（MD -0.30（95%CI -2.26至1.66））、造影剂剂量（MD -6.29（95%CI -25.23至12.65））、剂量面积乘积（MD -642.57（95%CI -2434.20至1149.07））、主要不良心血管事件（MACE）（OR 0.54（95%CI 0.15至1.96））和死亡率（OR 1.86（95%CI 0.82至4.22））在两种干预措施之间无显著差异。序贯分析显示为真阳性结果。我们的荟萃分析表明，与手动PCI相比，机器人辅助PCI的空气比释动能降低，但总体上具有统计学意义的结局较少。与之前的分析相比，本研究结果提供了对现有证据更全面的看法。
