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Guan S, Li T, Meng C, Ma L. Multi-mode information fusion navigation system for robot-assisted vascular interventional surgery. BMC Surg 2023; 23:51. [PMID: 36894932 PMCID: PMC9996930 DOI: 10.1186/s12893-023-01944-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 02/23/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Minimally invasive vascular intervention (MIVI) is a powerful technique for the treatment of cardiovascular diseases, such as abdominal aortic aneurysm (AAA), thoracic aortic aneurysm (TAA) and aortic dissection (AD). Navigation of traditional MIVI surgery mainly relies only on 2D digital subtraction angiography (DSA) images, which is hard to observe the 3D morphology of blood vessels and position the interventional instruments. The multi-mode information fusion navigation system (MIFNS) proposed in this paper combines preoperative CT images and intraoperative DSA images together to increase the visualization information during operations. RESULTS The main functions of MIFNS were evaluated by real clinical data and a vascular model. The registration accuracy of preoperative CTA images and intraoperative DSA images were less than 1 mm. The positioning accuracy of surgical instruments was quantitatively assessed using a vascular model and was also less than 1 mm. Real clinical data used to assess the navigation results of MIFNS on AAA, TAA and AD. CONCLUSIONS A comprehensive and effective navigation system was developed to facilitate the operation of surgeon during MIVI. The registration accuracy and positioning accuracy of the proposed navigation system were both less than 1 mm, which met the accuracy requirements of robot assisted MIVI.
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Affiliation(s)
- Shaoya Guan
- School of Engineers, Beijing Institute of Petrochemical Technology, Beijing, China
| | - Tianqi Li
- School of Information Engineering, Beijing Institute of Petrochemical Technology, Beijing, China
| | - Cai Meng
- School of Astronautics, Beihang University, Beijing, China
| | - Limei Ma
- School of Engineers, Beijing Institute of Petrochemical Technology, Beijing, China.
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2
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Duan W, Akinyemi T, Du W, Ma J, Chen X, Wang F, Omisore O, Luo J, Wang H, Wang L. Technical and Clinical Progress on Robot-Assisted Endovascular Interventions: A Review. MICROMACHINES 2023; 14:197. [PMID: 36677258 PMCID: PMC9864595 DOI: 10.3390/mi14010197] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/05/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Prior methods of patient care have changed in recent years due to the availability of minimally invasive surgical platforms for endovascular interventions. These platforms have demonstrated the ability to improve patients' vascular intervention outcomes, and global morbidities and mortalities from vascular disease are decreasing. Nonetheless, there are still concerns about the long-term effects of exposing interventionalists and patients to the operational hazards in the cath lab, and the perioperative risks that patients undergo. For these reasons, robot-assisted vascular interventions were developed to provide interventionalists with the ability to perform minimally invasive procedures with improved surgical workflow. We conducted a thorough literature search and presented a review of 130 studies published within the last 20 years that focused on robot-assisted endovascular interventions and are closely related to the current gains and obstacles of vascular interventional robots published up to 2022. We assessed both the research-based prototypes and commercial products, with an emphasis on their technical characteristics and application domains. Furthermore, we outlined how the robotic platforms enhanced both surgeons' and patients' perioperative experiences of robot-assisted vascular interventions. Finally, we summarized our findings and proposed three key milestones that could improve the development of the next-generation vascular interventional robots.
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Affiliation(s)
- Wenke Duan
- Academy for Engineering and Technology, Fudan University, Shanghai 200433, China
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Toluwanimi Akinyemi
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Wenjing Du
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Jun Ma
- Shenzhen Raysight Intelligent Medical Technology Co., Ltd., Shenzhen 518063, China
| | - Xingyu Chen
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Fuhao Wang
- Academy for Engineering and Technology, Fudan University, Shanghai 200433, China
| | - Olatunji Omisore
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Engineering Laboratory for Diagnosis & Treatment Key Technologies of Interventional Surgical Robots, Shenzhen 518055, China
| | - Jingjing Luo
- Academy for Engineering and Technology, Fudan University, Shanghai 200433, China
| | - Hongbo Wang
- Academy for Engineering and Technology, Fudan University, Shanghai 200433, China
| | - Lei Wang
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Shenzhen Engineering Laboratory for Diagnosis & Treatment Key Technologies of Interventional Surgical Robots, Shenzhen 518055, China
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3
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A survey of catheter tracking concepts and methodologies. Med Image Anal 2022; 82:102584. [DOI: 10.1016/j.media.2022.102584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/01/2022] [Accepted: 08/11/2022] [Indexed: 11/23/2022]
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Tahir A, Iqbal H, Usman M, Ghaffar A, Hafeez A. Cardiac X-ray image-based haptic guidance for robot-assisted coronary intervention: a feasibility study. Int J Comput Assist Radiol Surg 2022; 17:531-539. [PMID: 35041132 DOI: 10.1007/s11548-022-02563-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/06/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE Effective and efficient haptic guidance is desirable for tele-operated robotic surgery because it has a potential to enhance surgeon's skills, especially in coronary interventions where surgeon loses both an eye-hand coordination and a direct sight to the organ. This paper proposes a novel haptic guidance procedure-both kinesthetic and cutaneous, which solely depends upon X-ray images, for tele-robotic system that assists an efficient navigation of the guidewire towards the target location during a coronary intervention. METHODS Proposed methodology requires cardiologists to draw virtual fixtures (VFs) on angiograms as a preoperative procedure. During an operation, these VFs direct the guidewire to the desired coronary vessel. For this, the position and orientation of guidewire tip are calculated with respect to VFs' anatomy, using image processing on the real-time 2D fluoroscopic images. The haptic feedbacks are then rendered on to the master device depending on the interaction with attractive and repulsive, guidance and forbidden region VFs. RESULTS A feasibility study in the laboratory environment is performed by using a webcam as an image acquisition device and a phantom-based coronary vessel model. The subsequent statistical analysis shows that, on an average, a decrease of approx. 37% in task completion time is observed with haptic feedback. Moreover, haptic guidance is found effective for most difficult branch, whereas there is a minimal significance of such haptics for the easiest branch. CONCLUSIONS The proposed haptic guidance procedure may assist cardiologists for an efficient and effective guidewire navigation during a surgical procedure. The cutaneous haptics (vibration feedback) is found more helpful in coronary interventions compared with kinesthetic haptics (force feedback).
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Affiliation(s)
- Abdullah Tahir
- Department of Mechatronics and Control Engineering, University of Engineering and Technology Lahore, Faisalabad Campus, Lahore, Pakistan
| | - Hashim Iqbal
- Department of Mechatronics and Control Engineering, University of Engineering and Technology Lahore, Faisalabad Campus, Lahore, Pakistan
| | - Muhammad Usman
- Department of Mechatronics and Control Engineering, University of Engineering and Technology Lahore, Faisalabad Campus, Lahore, Pakistan
| | - Asim Ghaffar
- Department of Mechatronics and Control Engineering, University of Engineering and Technology Lahore, Faisalabad Campus, Lahore, Pakistan.
| | - Awais Hafeez
- Department of Mechatronics and Control Engineering, University of Engineering and Technology Lahore, Faisalabad Campus, Lahore, Pakistan
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Yang C, Guo S, Bao X. An Isomorphic Interactive Device for the Interventional Surgical Robot after In Vivo Study. MICROMACHINES 2022; 13:mi13010111. [PMID: 35056276 PMCID: PMC8778927 DOI: 10.3390/mi13010111] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 02/04/2023]
Abstract
Interventional surgical robots are widely used in neurosurgery to improve surgeons’ working environment and surgical safety. Based on the actual operational needs of surgeons’ feedback during preliminary in vivo experiments, this paper proposed an isomorphic interactive master controller for the master–slave interventional surgical robot. The isomorphic design of the controller allows surgeons to utilize their surgical skills during remote interventional surgeries. The controller uses the catheter and guidewire as the operating handle, the same as during actual surgeries. The collaborative operational structure design and the working methods followed the clinical operational skills. The linear force feedback and torque feedback devices were designed to improve the safety of surgeries under remote operating conditions. An eccentric force compensation was conducted to achieve accurate force feedback. Several experiments were carried out, such as calibration experiments, master–slave control performance evaluation experiments, and operation comparison experiments on the novel and previously used controllers. The experimental results show that the proposed controller can perform complex operations in remote surgery applications and has the potential for further animal experiment evaluations.
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Affiliation(s)
- Cheng Yang
- School of Automation, Beijing Institute of Technology, Beijing 100081, China;
- Key Laboratory of Convergence Biomedical Engineering System and Healthcare Technology, The Ministry of Industry and Information Technology, Beijing Institute of Technology, Beijing 100081, China
| | - Shuxiang Guo
- School of Automation, Beijing Institute of Technology, Beijing 100081, China;
- Key Laboratory of Convergence Biomedical Engineering System and Healthcare Technology, The Ministry of Industry and Information Technology, Beijing Institute of Technology, Beijing 100081, China
- Faculty of Engineering, Kagawa University, 2217-20 Hayashi-cho, Takamatsu 760-8521, Japan
- Correspondence: (S.G.); (X.B.)
| | - Xianqiang Bao
- Key Laboratory of Convergence Biomedical Engineering System and Healthcare Technology, The Ministry of Industry and Information Technology, Beijing Institute of Technology, Beijing 100081, China
- Correspondence: (S.G.); (X.B.)
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6
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Lemos PA, Franken M, Mariani J, Pitta FG, Oliveira FA, Cunha-Lima G, Caixeta AM, Almeida BO, Garcia RG. Use of robotic assistance to reduce proximity and air-sharing during percutaneous cardiovascular intervention. Future Cardiol 2021; 17:865-873. [PMID: 33834847 DOI: 10.2217/fca-2021-0024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Traditional percutaneous cardiovascular interventions require close physical proximity between the patients and the healthcare team, posing occupational hazards that range from radiation exposure to interpersonal air contamination. Materials & methods: Prospective single-arm pilot study (n = 10) to investigate robotic-assisted intervention as a strategy to reduce proximity during the procedure. Primary end point: composite of angiographic success, intervention performed with the team positioned >2 meters from the patient for ≥50% procedure duration, and absence of in-hospital death or acute target lesion occlusion. Results: The composite primary end point was achieved in 100% of cases. Conclusion: Robotic-assisted percutaneous intervention provided successful invasive treatment while reducing proximity and shared air space between the care-delivery team and the patient during the procedure. Trial registration number: NCT04379453 (Clinicaltrials.gov).
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Affiliation(s)
- Pedro A Lemos
- Hospital Israelita Albert Einstein, Sao Paulo-SP, Brazil
| | | | - Jose Mariani
- Hospital Israelita Albert Einstein, Sao Paulo-SP, Brazil
| | - Fabio G Pitta
- Hospital Israelita Albert Einstein, Sao Paulo-SP, Brazil
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7
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Lemos PA, Franken M, Mariani J, Pitta FG, Oliveira FAP, Cunha-Lima G, Caixeta AM, Almeida BO, Garcia RG. Robotic-assisted intervention strategy to minimize air exposure during the procedure: a case report of myocardial infarction and COVID-19. Cardiovasc Diagn Ther 2020; 10:1345-1351. [PMID: 33224759 PMCID: PMC7666926 DOI: 10.21037/cdt-20-521] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/05/2020] [Indexed: 12/12/2022]
Abstract
Percutaneous coronary interventions (PCI) is traditionally a manual procedure executed by one or more operators positioned at a close distance from the patient. The ongoing pandemic of coronavirus disease 2019 (COVID-19) has imposed severe restrictions to such an interventional environment. The novel SARS-CoV-2 virus that causes COVID-19 is transmitted mainly through expelled respiratory particles, which are known to travel approximately 3-6 feet away from infected persons. During PCI, that contamination range obligatorily poses the team and the patient to direct air exposure. We herein present a case report with the description of a minimum-contact strategy to reduce interpersonal air exposure during PCI. The approach designed to minimize proximity between the patient and the healthcare team included the performance of robotic-assisted PCI, operated by unscrubbed cardiac interventionalists from a control cockpit located outside the catheterization suite. Also included, was the delineation of the potential zone of respiratory particle spread; a circle measuring 4 meters (13.1 feet) in diameter was traced on the floor of the cath lab with red tape, centered on the patient's mouth and nose. The team was rigorously trained and advised to minimize time spent within the 4-meter perimeter as much as possible during the procedure. Following this strategy, a 60-year-old male with non-ST-elevation myocardial infarction and COVID-19 was treated with successful coronary implantation of two stents in the obtuse marginal branch and one stent in the circumflex artery. The total duration of the procedure was 103 minutes and 22 seconds. During most of the procedure, the 4-meter spread zone was not entered by any personnel. For each individual team member, the proposed strategy was effective in ensuring that they stayed outside of the 4-meter area for the majority of their work time, ranging from 96.9% to 59.7% of their respective participation. This case report illustrates the potential of robotic-assisted percutaneous coronary intervention in reducing physical proximity between the team and the patient during the procedure.
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Affiliation(s)
- Pedro A Lemos
- Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil
| | | | - Jose Mariani
- Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil
| | - Fabio G Pitta
- Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil
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8
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da Veiga T, Chandler JH, Lloyd P, Pittiglio G, Wilkinson NJ, Hoshiar AK, Harris RA, Valdastri P. Challenges of continuum robots in clinical context: a review. ACTA ACUST UNITED AC 2020. [DOI: 10.1088/2516-1091/ab9f41] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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9
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Patel TM, Shah SC, Soni YY, Radadiya RC, Patel GA, Tiwari PO, Pancholy SB. Comparison of Robotic Percutaneous Coronary Intervention With Traditional Percutaneous Coronary Intervention: A Propensity Score-Matched Analysis of a Large Cohort. Circ Cardiovasc Interv 2020; 13:e008888. [PMID: 32406263 DOI: 10.1161/circinterventions.119.008888] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Robotic percutaneous coronary intervention (R-PCI) has been shown to benefit the operator but has not shown any significant benefit to the patient. We sought to compare a large cohort of R-PCI to traditional percutaneous coronary intervention (PCI) procedures performed at a tertiary care center in the same time frame. METHODS A total of 996 consecutive patients referred for PCI between December 2017 and March 2019 were studied, of which 310 (31.1%) patients were selected to undergo R-PCI and 686 (68.9%) patients underwent traditional PCI. The coprimary study outcome measures were air kerma, dose-area product, fluoroscopy time, volume of contrast, and total procedural time. Caliper propensity-matching technique was used (caliper, 0.05) to match each R-PCI patient to the nearest traditional PCI patient without replacement. RESULTS Air kerma (mGy; median [interquartile range]; P; 884 [537-1398] versus 1110 [699-1498]; P=0.002) and dose-area product (cGycm2; 4734 [2695-7746] versus 5746 [3751-7833]; P=0.003) were significantly lower in the R-PCI group. There was no difference in fluoroscopy time (minutes; 5.51 [3.53-8.31] versus 5.48 [3.31-9.37]; P=0.936) and contrast volume (mL; 130 [103-170] versus 140 [100-180]; P=0.905). Total procedural time (minutes) was significantly higher in the R-PCI group (27 [21-40] versus 37 [27-50]; P<0.0005). CONCLUSIONS R-PCI is associated with a significant decrease in radiation exposure to the patient with no increase in fluoroscopy time, as well as contrast utilization, and a minor increase in procedure duration compared with traditional PCI.
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Affiliation(s)
- Tejas M Patel
- From the Apex Heart Institute, Ahmedabad, India (T.M.P., S.C.S., Y.Y.S., R.C.R., P.O.T.)
| | - Sanjay C Shah
- From the Apex Heart Institute, Ahmedabad, India (T.M.P., S.C.S., Y.Y.S., R.C.R., P.O.T.)
| | - Yash Y Soni
- From the Apex Heart Institute, Ahmedabad, India (T.M.P., S.C.S., Y.Y.S., R.C.R., P.O.T.)
| | - Rajni C Radadiya
- From the Apex Heart Institute, Ahmedabad, India (T.M.P., S.C.S., Y.Y.S., R.C.R., P.O.T.)
| | - Gaurav A Patel
- The Wright Center for Graduate Medical Education, Scranton, PA (G.A.P., S.B.P.)
| | - Pradyot O Tiwari
- From the Apex Heart Institute, Ahmedabad, India (T.M.P., S.C.S., Y.Y.S., R.C.R., P.O.T.)
| | - Samir B Pancholy
- The Wright Center for Graduate Medical Education, Scranton, PA (G.A.P., S.B.P.)
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10
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Initial Experience in a Pig Model of Robotic-Assisted Intracranial Arteriovenous Malformation (AVM) Embolization. Oper Neurosurg (Hagerstown) 2019; 19:205-209. [DOI: 10.1093/ons/opz373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 09/02/2019] [Indexed: 11/15/2022] Open
Abstract
Abstract
BACKGROUND
Robotic assistance for coronary and peripheral vascular pathologies is steadily gaining popularity. However, it has yet to be applied to neurovascular intervention.
OBJECTIVE
To establish the feasibility of the CorPath® GRX robotic-assisted platform (Corindus Inc, Waltham, Massachusetts) for intracranial arteriovenous malformation (AVM) embolization.
METHODS
This robotic system was used to embolize intracranial AVMs (n = 4) in 2 anesthetized pigs, under controlled conditions appropriate for clinical intervention. Initially, a catheter was manually introduced into the common carotid artery (CCA). Then, the robotic system was used to advance the catheter into the ascending pharyngeal artery (APA) towards the rete mirabilis, which was used as a model for an AVM, using 0.014 in guidewires and 2.4F/1.7F microcatheters. After doing a pre-embolization APA run, which demonstrated good visualization of the rete, dimethyl sulfoxide (DMSO) was instilled into the microcatheter. A negative roadmap was then done, and Onyx was used to embolize the rete.
RESULTS
All 4 AVMs were completely obliterated with no complications, including no contrast extravasation, dissection, thrombosis, or other vascular injury.
CONCLUSION
This study is the first to demonstrate the feasibility of a robotic-assisted platform for intracranial AVM embolization.
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Lopes MACQ, Oliveira GMMD, Ribeiro ALP, Pinto FJ, Rey HCV, Zimerman LI, Rochitte CE, Bacal F, Polanczyk CA, Halperin C, Araújo EC, Mesquita ET, Arruda JA, Rohde LEP, Grinberg M, Moretti M, Caramori PRA, Botelho RV, Brandão AA, Hajjar LA, Santos AF, Colafranceschi AS, Etges APBDS, Marino BCA, Zanotto BS, Nascimento BR, Medeiros CR, Santos DVDV, Cook DMA, Antoniolli E, Souza Filho EMD, Fernandes F, Gandour F, Fernandez F, Souza GEC, Weigert GDS, Castro I, Cade JR, Figueiredo Neto JAD, Fernandes JDL, Hadlich MS, Oliveira MAP, Alkmim MB, Paixão MCD, Prudente ML, Aguiar Netto MAS, Marcolino MS, Oliveira MAD, Simonelli O, Lemos Neto PA, Rosa PRD, Figueira RM, Cury RC, Almeida RC, Lima SRF, Barberato SH, Constancio TI, Rezende WFD. Guideline of the Brazilian Society of Cardiology on Telemedicine in Cardiology - 2019. Arq Bras Cardiol 2019; 113:1006-1056. [PMID: 31800728 PMCID: PMC7020958 DOI: 10.5935/abc.20190205] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Carlos Eduardo Rochitte
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP - Brazil
| | - Fernando Bacal
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP - Brazil
| | - Carisi Anne Polanczyk
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS - Brazil
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brazil
- Instituto de Avaliação de Tecnologias em Saúde (IATS), Porto Alegre, RS - Brazil
| | | | | | | | | | | | - Max Grinberg
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP - Brazil
| | - Miguel Moretti
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP - Brazil
| | | | - Roberto Vieira Botelho
- Instituto do Coração do Triângulo (ICT), Uberlândia, MG - Brazil
- International Telemedical Systems do Brasil (ITMS), Uberlândia, MG - Brazil
| | | | - Ludhmila Abrahão Hajjar
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP - Brazil
| | | | | | | | - Bárbara Campos Abreu Marino
- Hospital Madre Teresa, Belo Horizonte, MG - Brazil
- Pontifícia Universidade Católica de Minas Gerais (PUCMG), Belo Horizonte, MG - Brazil
| | - Bruna Stella Zanotto
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brazil
- Instituto de Avaliação de Tecnologias em Saúde (IATS), Porto Alegre, RS - Brazil
| | - Bruno Ramos Nascimento
- Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brazil
| | | | | | - Daniela Matos Arrowsmith Cook
- Hospital Pró-Cardíaco, Rio de Janeiro, RJ - Brazil
- Hospital Copa Star, Rio de Janeiro, RJ - Brazil
- Hospital dos Servidores do Estado do Rio de Janeiro, Rio de Janeiro, RJ - Brazil
| | | | - Erito Marques de Souza Filho
- Universidade Federal Fluminense (UFF), Rio de Janeiro, RJ - Brazil
- Universidade Federal Rural do Rio de Janeiro, Seropédica, RJ - Brazil
| | | | - Fabio Gandour
- Universidade de Brasília (UnB), Brasília, DF - Brazil
| | | | | | | | - Iran Castro
- Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre, RS - Brazil
- Fundação Universitária de Cardiologia, Porto Alegre, RS - Brazil
| | | | | | | | - Marcelo Souza Hadlich
- Fleury Medicina e Saúde, Rio de Janeiro, RJ - Brazil
- Rede D'Or, Rio de Janeiro, RJ - Brazil
- Unimed-Rio, Rio de Janeiro, RJ - Brazil
| | | | - Maria Beatriz Alkmim
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brazil
- Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brazil
| | | | | | | | | | | | - Osvaldo Simonelli
- Conselho Regional de Medicina do Estado de São Paulo, São Paulo, SP - Brazil
- Instituto Paulista de Direito Médico e da Saúde (IPDMS), Ribeirão Preto, SP - Brazil
| | | | - Priscila Raupp da Rosa
- Hospital Israelita Albert Einstein, São Paulo, SP - Brazil
- Hospital Sírio Libanês, São Paulo, SP - Brazil
| | | | | | | | | | - Silvio Henrique Barberato
- CardioEco-Centro de Diagnóstico Cardiovascular, Curitiba, PR - Brazil
- Quanta Diagnóstico e Terapia, Curitiba, PR - Brazil
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Abstract
PURPOSE OF REVIEW To review the contemporary evidence for robotic-assisted percutaneous coronary and vascular interventions, discussing its current capabilities, limitations, and potential future applications. RECENT FINDINGS Robotic-assisted cardiovascular interventions significantly reduce radiation exposure and orthopedic strains for interventionalists, while maintaining high rates of device and clinical success. The PRECISE and CORA-PCI studies demonstrated the safety and efficacy of robotic-assisted percutaneous coronary intervention (PCI) in increasingly complex coronary lesions. The RAPID study demonstrated similar findings in peripheral vascular interventions (PVI). Subsequent studies have demonstrated the safety and efficacy of second-generation devices, with automations mimicking manual PCI techniques. While innovations such as telestenting continue to bring excitement to the field, major limitations remain-particularly the lack of randomized trials comparing robotic-assisted PCI with manual PCI. Robotic technology has successfully been applied to multiple cardiovascular procedures. There are limited data to evaluate outcomes with robotic-assisted PCI and other robotic-assisted cardiovascular procedures, but existing data show some promise of improving the precision of PCI while decreasing occupational hazards associated with radiation exposure.
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Affiliation(s)
- Zachary K Wegermann
- Division of Cardiology, Duke University Medical Center, Durham, NC, USA. .,Duke Clinical Research Institute, Durham, NC, USA.
| | - Rajesh V Swaminathan
- Division of Cardiology, Duke University Medical Center, Durham, NC, USA.,Duke Clinical Research Institute, Durham, NC, USA
| | - Sunil V Rao
- Division of Cardiology, Duke University Medical Center, Durham, NC, USA.,Duke Clinical Research Institute, Durham, NC, USA
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