Author + information
- S193687981502083X-171e830cd1dcc9034ad14cdf44624cceAndrew O'Brien1,
- S193687981502083X-c9d7995a4a63a08465cba1e52e115e4fAndrew LaCombe1,
- S193687981502083X-95eb8e730574b6dbcf0efc43e5c8c933J.D. Sheets1,
- S193687981502083X-c95177966dcb45c813f7adede42163d5Ryan Farley1,
- S193687981502083X-2756ce77819f38a4fe6798400f71ac26Edwin Mandieka1,
- S193687981502083X-6655356ce94205b23b282148a25e21abJacob Bundy1,
- S193687981502083X-b7b66f6edd8623e8380cc90434ff63c5Austin Clarey1,
- S193687981502083X-60476037fcaf6848be38330ee4db5f7eAbbey Mulder2,
- S193687981502083X-fa502a35a9a772b6cfc23f1afbcf9bbcMatthew Elmore2,
- S193687981502083X-ec5886024309212374af79cbe5af40f2Jessica Campbell2,
- S193687981502083X-ee1a2e7fa3c6c5f0921cd4618cde4d3cStacie VanOosterhout2,
- S193687981502083X-280fa5201d53e6b09c40b8bfedf9f599Mark Jacoby2,
- S193687981502083X-73fc0b3e3c753ebcc40c8612c06ffd9bDavid Wohns2 and
- S193687981502083X-e4d6f3ef0958ac92635e588c292a3e67Ryan Madder2
A robotic system for performing remote-controlled angioplasty and stent placement is now in clinical use in the US. This robotic system allows the operator to perform percutaneous coronary intervention (PCI) while seated in a lead-lined cockpit, thereby minimizing radiation exposure and eliminating the need for lead apparel. The initial clinical study describing robotic-PCI excluded patients with coronary thrombosis, and thus the role of robotic-PCI in myocardial infarction remains largely unknown. This study describes the initial clinical experience and procedural success rates in a small cohort of patients with acute myocardial infarction undergoing robotic-PCI.
Data were collected from consecutive robotic-PCI cases performed at a single center in patients with acute myocardial infarction. Target coronary lesions were classified angiographically according to the ACC/AHA lesion classification system. The primary measure of interest was procedural success, defined as <30% residual stenosis after PCI in the absence of associated death or repeat revascularization prior to hospital discharge. Procedural duration, defined as the time from sheath insertion to removal of the guide catheter, was recorded for all cases.
During the study period, robotic-PCI was performed in 17 patients (age 59 ± 10; 71% male) with acute myocardial infarction. In all cases radial arterial access was used for performance of robotic-PCI. Baseline angiographic lesion complexities were Type A in 11.8% cases, Type B1 in 11.8%, Type B2 in 52.9%, and Type C in 17.6%. In 10 (58.8%) cases, an angiographic filling defect consistent with thrombus was present at the culprit lesion site prior to PCI. Robotic-PCI resulted in procedural success in all 17 (100%) cases. The total procedural duration for these cases was 69 ± 25 minutes. None of the patients undergoing robotic-PCI experienced death or repeat revascularization prior to hospital discharge.
In this small cohort of patients with acute myocardial infarction, robotic-PCI was associated with a high procedural success rate, no cases of death or repeat revascularization prior to hospital discharge, and acceptable procedural times. These preliminary observations support the performance of larger studies to determine the role of robotic-PCI in the treatment of acute myocardial infarction.