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A randomized trial of bifurcation stenting technique in chronic total occlusions percutaneous coronary intervention Fate of post-procedural malapposition of everolimus-eluting polymeric bioresorbable scaffold and everolimus-eluting cobalt chromiummetallic stent in human coronary arteries: sequential assessment with optical coherence tomography in ABSORB Japan trial Volumetric characterization of human coronary calcification by frequency-domain optical coherence tomography Long-term clinical outcome after fractional flow reserve-guided treatment in patients with angiographically equivocal left main coronary artery stenosis Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data Robustness of Fractional Flow Reserve for Lesion Assessment in Non-Infarct-Related Arteries of Patients With Myocardial Infarction Two-year outcomes of everolimus vs. paclitaxel-eluting stent for the treatment of unprotected left main lesions: a propensity score matching comparison of patients included in the French Left Main Taxus (FLM Taxus) and the LEft MAin Xience (LEMAX) registries Fractional Flow Reserve–Guided PCI for Stable Coronary Artery Disease

Review ArticleEpub 2017 Sep 15; Volume 15, 2017 - Issue 11

JOURNAL:Expert Rev Cardiovasc Ther. Article Link

Robotics in percutaneous cardiovascular interventions

Pourdjabbar A, Ang L, Mahmud E et al. Keywords: Robotics; coronary artery disease; percutaneous coronary intervention; peripheral arterial disease; radiation safety

ABSTRACT

Introduction - The fundamental technique of performing percutaneous cardiovascular (CV) interventions has remained unchanged and requires operators to wear heavy lead aprons to minimize exposure to ionizing radiation. Robotic technology is now being utilized in interventional cardiology partially as a direct result of the increasing appreciation of the long-term occupational hazards of the field. This review was undertaken to report the clinical outcomes of percutaneous robotic coronary and peripheral vascular interventions.

Areas covered - A systematic literature review of percutaneous robotic CV interventions was undertaken. The safety and feasibility of percutaneous robotically-assisted CV interventions has been validated in simple to complex coronary disease, and iliofemoral disease. Studies have shown that robotically-assisted PCI significantly reduces operator exposure to harmful ionizing radiation without compromising procedural success or clinical efficacy. In addition to the operator benefits, robotically-assisted intervention has the potential for patient advantages by allowing more accurate lesion length measurement, precise stent placement and lower patient radiation exposure. However, further investigation is required to fully elucidate these potential benefits.

Expert commentary - Incremental improvement in robotic technology and telecommunications would enable treatment of an even broader patient population, and potentially provide remote robotic PCI.