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Bay B, Kiwus LM, Goßling A, Koester L, Blaum C, Schrage B, Clemmensen P, Blankenberg S, Waldeyer C, Seiffert M, Brunner FJ. Procedural and one-year outcomes of robotic-assisted versus manual percutaneous coronary intervention. EUROINTERVENTION 2024; 20:56-65. [PMID: 38165113 PMCID: PMC10756222 DOI: 10.4244/eij-d-23-00375] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/24/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Robotic-assisted percutaneous coronary intervention (rPCI) has proven to be feasible and safe. Comparative analyses of rPCI versus manual PCI (mPCI) are scarce. AIMS We aimed to investigate procedural aspects and outcomes of rPCI using the second-generation CorPath GRX Vascular Robotic System compared with mPCI in patients with chronic coronary syndrome and non-ST-segment elevation myocardial infarction acute coronary syndrome. METHODS From January to April 2021, 70 patients underwent rPCI at the University Heart & Vascular Center Hamburg-Eppendorf and were recruited into the INTERCATH study. By propensity score matching, a control cohort of 210 patients who underwent mPCI from 2015-2021 was identified. Co-primary endpoints were one-year all-cause mortality and major adverse cardiovascular events (MACE) as a composite of cardiovascular death, unplanned target lesion revascularisation, myocardial infarction, and stroke. RESULTS The median age of the patients (n=280) was 70.7 (25th percentile-75th percentile: 62.0-78.0) years, and 24.6% were female. The Gensini score (28.5 [16.2-48.1] vs 28.0 [15.5-47.0]; p=0.78) was comparable between rPCI versus mPCI. During the PCI procedure, total contrast fluid volume did not differ, whilst longer fluoroscopy times (20.4 min [13.8-27.2] vs 14.4 min [10.4-24.3]; p=0.001) were documented in the rPCI versus mPCI cohort. After 12 months of follow-up, neither all-cause mortality (p=0.22) nor MACE (p=0.25) differed between the groups. CONCLUSIONS rPCI was associated with longer fluoroscopy times compared with mPCI, though without increased use of contrast medium. One-year follow-up revealed no differences in all-cause mortality or MACE, supporting the safety of a robotic-assisted approach.
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Affiliation(s)
- Benjamin Bay
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
- Center for Population Health Innovation (POINT), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Luisa M Kiwus
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alina Goßling
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Center for Population Health Innovation (POINT), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lukas Koester
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christopher Blaum
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benedikt Schrage
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
- Center for Population Health Innovation (POINT), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Clemmensen
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
- Center for Population Health Innovation (POINT), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Blankenberg
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
- Center for Population Health Innovation (POINT), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Waldeyer
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Moritz Seiffert
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
- Center for Population Health Innovation (POINT), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fabian J Brunner
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
- Center for Population Health Innovation (POINT), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Khokhar AA, Marrone A, Bermpeis K, Wyffels E, Tamargo M, Fernandez-Avilez F, Ruggiero R, Złahoda-Huzior A, Giannini F, Zelias A, Madder R, Dudek D, Beyar R. Latest Developments in Robotic Percutaneous Coronary Interventions. Interv Cardiol 2023; 18:e30. [PMID: 38213745 PMCID: PMC10782427 DOI: 10.15420/icr.2023.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 10/02/2023] [Indexed: 01/13/2024] Open
Abstract
Since the first robotic-assisted percutaneous coronary intervention procedure (R-PCI) was performed in 2004, there has been a steady evolution in robotic technology, combined with a growth in the number of robotic installations worldwide and operator experience. This review summarises the latest developments in R-PCI with a focus on developments in robotic technology, procedural complexity, tele-stenting and training methods, which have all contributed to the global expansion in R-PCI.
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Affiliation(s)
- Arif A Khokhar
- Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS TrustLondon, UK
- Digital Innovations and Robotics Hub, Clinical Research Center IntercardKrakow, Poland
| | - Andrea Marrone
- Cardiovascular Institute, Azienda Ospedaliero-Universataria di FerraraCona, Italy
| | - Konstantinos Bermpeis
- Department of Cardiology, AHEPA University General HospitalThessaloniki, Greece
- Cardiovascular Center Aalst, OLV-ClinicAalst, Belgium
| | - Eric Wyffels
- Cardiovascular Center Aalst, OLV-ClinicAalst, Belgium
| | - Maria Tamargo
- Department of Cardiology, Hospital General Universitario Gregorio MaranonMadrid, Spain
| | | | | | - Adriana Złahoda-Huzior
- Digital Innovations and Robotics Hub, Clinical Research Center IntercardKrakow, Poland
- Department of Measurement and Electronics, AGH University of Science and TechnologyKrakow, Poland
| | - Francesco Giannini
- Interventional Cardiology Unit, IRCCS Galeazzi Sant’AmbrogioMilan, Italy
| | - Aleksander Zelias
- Digital Innovations and Robotics Hub, Clinical Research Center IntercardKrakow, Poland
- Center for Invasive Cardiology, Electrotherapy and AngiologyNowy Sacz, Poland
| | - Ryan Madder
- Frederik Meijer Heart and Vascular Institute, Spectrum HealthGrand Rapids, MI, US
| | - Dariusz Dudek
- Center of Digital Medicine and Robotics, Jagiellonian University Medical CollegeKrakow, Poland
- GVM Care & Research, Maria Cecilia HospitalCotignola, Italy
| | - Rafael Beyar
- Department of Cardiology, Rambam Health Care Campus and the TechnionHaifa, Israel
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Wójcik S, Rulkiewicz A, Pruszczyk P, Lisik W, Poboży M, Domienik-Karłowicz J. Beyond ChatGPT: What does GPT-4 add to healthcare? The dawn of a new era. Cardiol J 2023; 30:1018-1025. [PMID: 37830256 PMCID: PMC10713213 DOI: 10.5603/cj.97515] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/03/2023] [Indexed: 10/14/2023] Open
Abstract
Over the past few years, artificial intelligence (AI) has significantly improved healthcare. Once the stuff of science fiction, AI is now widely used, even in our daily lives - often without us thinking about it. All healthcare professionals - especially executives and medical doctors - need to understand the capabilities of advanced AI tools and other breakthrough innovations. This understanding will allow them to recognize opportunities and threats emerging technologies can bring to their organizations. We hope to contribute to a meaningful public discussion about the role of this new type of AI and how our approach to healthcare and medicine can best evolve with the rapid development of this technology. Since medicine learns by example, only a few possible uses of AI in medicine are provided, which merely outline the system's capabilities. Among the examples, it is worth highlighting the roles of AI in medical notes, education, preventive programs, consultation, triage and intervention. It is believed by the authors that large language models such as chat generative pre-trained transformer (ChatGPT) are reaching a level of maturity that will soon impact clinical medicine as a whole and improve the delivery of individualized, compassionate, and scalable healthcare. It is unlikely that AI will replace physicians in the near future. The human aspects of care, including empathy, compassion, critical thinking, and complex decision-making, are invaluable in providing holistic patient care beyond diagnosis and treatment decisions. The GPT-4 has many limitations and cannot replace direct contact between an experienced physician and a patient for even the most seemingly simple consultations, not to mention the ethical and legal aspects of responsibility for diagnosis.
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Affiliation(s)
| | | | - Piotr Pruszczyk
- Department of Internal Medicine and Cardiology with the Center for Diagnosis and Treatment of Venous Thromboembolism, Medical University of Warsaw, Poland
| | - Wojciech Lisik
- Department of General and Transplantation Surgery, Medical University of Warsaw, Poland
| | - Marcin Poboży
- Cichowski Pobozy Healthcare Facility, Maciejowice, Poland
| | - Justyna Domienik-Karłowicz
- Department of Internal Medicine and Cardiology with the Center for Diagnosis and Treatment of Venous Thromboembolism, Medical University of Warsaw, Poland.
- LUX MED Llc, Warsaw, Poland.
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