NYMC Faculty Publications

Robotic Assisted versus Manual Percutaneous Coronary Intervention: Systematic Review and Meta-Analysis

Rahul Gupta, From the Department of Cardiology, Lehigh Valley Heart Institute, Lehigh Valley Health Network, Allentown, PA.Follow
Aaqib H. Malik, Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY.Follow
Jeffrey Shi Chan, Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
Huang Lawrence, Department of Internal Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY.
Anila Mehta, Department of Internal Medicine, Carle Foundation Hospital, Urbana, IL.Follow
Vikramaditya Samala Venkata, Department of Medicine, Cheshire Medical Center, Dartmouth-Hitchcock Keene, Keene, NH.
Surya K. Aedma, Department of Internal Medicine, Carle Foundation Hospital, Urbana, IL.Follow
Purva Ranchal, Department of Medicine, Boston University, Boston, MA.
Kartik Dhaduk, Department of Medicine, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA.
Wilbert S. Aronow, Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY.Follow
Apurva V. Vyas, From the Department of Cardiology, Lehigh Valley Heart Institute, Lehigh Valley Health Network, Allentown, PA.
Sanjay S. Mehta, Department of Cardiology, Heart and Vascular Institute, Carle Foundation Hospital, Urbana, IL.Follow
William G. Combs, From the Department of Cardiology, Lehigh Valley Heart Institute, Lehigh Valley Health Network, Allentown, PA.
William H. Frishman, Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY.Follow
Nainesh C. Patel, From the Department of Cardiology, Lehigh Valley Heart Institute, Lehigh Valley Health Network, Allentown, PA.Follow

Author Type(s)

Faculty, Resident/Fellow

DOI

10.1097/CRD.0000000000000445

Journal Title

Cardiology in Review

First Page

24

Last Page

29

Document Type

Article

Publication Date

1-1-2024

Department

Medicine

Abstract

INTRODUCTION: Robotics in percutaneous coronary intervention (R-PCI) has been one such area of advancement where potential benefits may include reduced operator radiation exposure, improved outcomes, and reduced rate of adverse events. Limited data exist about the benefits of R-PCI versus conventional manual PCI (M-PCI). We appraised the latest evidence in the form of a meta-analysis of observational and retrospective studies. METHODS: A comprehensive literature search was performed in PubMed, Embase, and Cochrane to identify relevant clinical studies. Summary effects were calculated using a DerSimonian and Laird random-effects model as the pooled odds ratio or mean differences (MDs) with 95% confidence intervals (CIs). All studies adhering to the inclusion criteria of direct comparisons between R-PCI and M-PCI were evaluated. RESULTS: Seven studies with a total of 2230 patients were identified. There was significant decrease in the chest-level operator radiation exposure (MD = -442.32; 95% CI = -675.88 to -208.76), fluoroscopy time (MD = -1.46; 95% CI = -2.92 to 0.00), and amount of contrast used (MD = -18.28; 95% CI = -24.16 to -12.41) in the robotic group compared to the manual group. PCI time and the procedural success rate was not statistically different between the 2 groups. Clinical outcomes of major adverse cardiac events, all-cause mortality, and myocardial infarction were not different between the 2 groups. CONCLUSIONS: Robotic PCI is associated with reduced operator radiation exposure, fluoroscopy time, and amount of contrast used. While there is a significant reduction in the procedural characteristics with robotic PCI, the clinical outcomes are not different compared to M-PCI. R-PCI is safe and effective with potential benefits to both the operator and the patient simultaneously.

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