Robotic vs Manual Percutaneous Coronary Intervention-Boon or a Bane?

Author Type(s)

Faculty

Document Type

Abstract

Publication Date

5-2021

Journal Title

Journal of the American College of Cardiology

Department

Medicine

Abstract

Background

Robotics in percutaneous coronary intervention (PCI) has been one such area of advancement where potential benefits may include reduction in operator radiation exposure, contrast use, and reduced rate of adverse events. Limited data exists about the benefits of robotic assisted PCI vs conventional manual PCI. We appraised the latest evidence in the form of a meta-analysis of all randomized controlled trials (RCTs).

Methods

A comprehensive literature search was performed in PubMed, Embase, and Cochrane to identify relevant trials. Summary effects were calculated using a DerSimonian and Laird random effects model as odds ratio with 95% confidence intervals for all the clinical endpoints. All studies adhering to the inclusion criteria of direct comparisons between robotic and manual PCI were evaluated.

Results

Seven RCTs with 2,230 patients were identified. There was significant decrease in the chest-level operator radiation exposure in the robotic arm as compared to the conventional arm. Fluoroscopy time, PCI time and the amount of contrast used was not statistically different between the two groups. Also, rates of major adverse cardiac events, all-cause mortality, stroke and myocardial infarction were not different between the two groups.

Conclusion

Robotic PCI is associated with reduced operator radiation exposure. However, the clinical outcomes are not different compared to manual PCI.

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