Mahmud Ehtisham, Madder Ryan D, Wohns David H, Schussler Jeffrey M, Salisbury Adam, Campbell Paul, Patel Tejas M, Lombardi William L, Nicholson William J, Parikh Manish A, Kelm Natia, Waksman Ron, Lansky Alexandra J, Weisz Giora
Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center at UC San Diego Health, La Jolla, California.
Division of Cardiology, Frederik Meijer Heart & Vascular Institute, Spectrum Health, Grand Rapids, Michigan.
J Soc Cardiovasc Angiogr Interv. 2025 May 13;4(7):103655. doi: 10.1016/j.jscai.2025.103655. eCollection 2025 Jul.
Robotic percutaneous coronary intervention (R-PCI) reduces occupational hazards for interventional cardiologists. However, there is a lack of clinical data in a large patient cohort. The aims of this study were to evaluate the safety and efficacy of R-PCI with both the first (CorPath 200) and second (CorPath GRX) (Corindus, Siemens Company) generation robotic systems.
These prospective, multicenter, single-armed studies enrolled patients with symptomatic coronary artery disease from 2013-2017 (PRECISION; CorPath 200) and 2017-2020 (PRECISION GRX; CorPath GRX). The primary outcome measures were clinical success, defined as <30% residual stenosis in the absence of major adverse cardiovascular events, and technical success, defined as clinical success without conversion to manual PCI.
A total of 1734 R-PCI procedures (PRECISION: 754 procedures, 950 lesions; PRECISION GRX: 980 procedures, 1233 lesions) were performed. Clinical (96.9% and 98.1% PRECISION and PRECISION GRX respectively, = ns) and technical (89.6% and 89.2% PRECISION and PRECISION GRX respectively, = ns) success rates were similar. Higher clinical success rates were observed in moderate/severe calcification lesions, bifurcation lesions, and long lesions with the second-generation system, and higher technical success rates were observed with the second-generation system in moderate/severe calcification lesions, bifurcation lesions, and angulated lesions.
This multicenter experience with R-PCI demonstrates high clinical and technical success for patients treated with either the first- or second-generation robotic platform. Clinical and technical success rates with the second-generation robotic platform were higher for several complex lesion types. These data support the safety and efficacy of R-PCI in clinical practice.
机器人辅助经皮冠状动脉介入治疗（R-PCI）可降低介入心脏病专家的职业风险。然而，目前缺乏大量患者队列的临床数据。本研究旨在评估第一代（CorPath 200）和第二代（CorPath GRX）（科林达斯，西门子公司）机器人系统进行R-PCI的安全性和有效性。
这些前瞻性、多中心、单臂研究纳入了2013 - 2017年（PRECISION；CorPath 200）和2017 - 2020年（PRECISION GRX；CorPath GRX）有症状冠状动脉疾病的患者。主要结局指标为临床成功，定义为在无重大不良心血管事件的情况下残余狭窄<30%，以及技术成功，定义为临床成功且未转换为手动PCI。
共进行了1734例R-PCI手术（PRECISION：754例手术，950个病变；PRECISION GRX：980例手术，1233个病变）。临床成功率（PRECISION和PRECISION GRX分别为96.9%和98.1%，P = 无显著性差异）和技术成功率（PRECISION和PRECISION GRX分别为89.6%和89.2%，P = 无显著性差异）相似。第二代系统在中度/重度钙化病变、分叉病变和长病变中观察到更高的临床成功率，在中度/重度钙化病变、分叉病变和成角病变中第二代系统观察到更高的技术成功率。
这项R-PCI的多中心经验表明，使用第一代或第二代机器人平台治疗的患者临床和技术成功率都很高。第二代机器人平台在几种复杂病变类型中的临床和技术成功率更高。这些数据支持R-PCI在临床实践中的安全性和有效性。
