Author + information
- 1Frederik Meijer Heart & Vascular Institute, Spectrum Health, Grand Rapids, Michigan, United States
- 2University of Washington Medical Center, Seattle, Washington, United States
- 3NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, New York, United States
- 4Piedmont Heart Institute, Atlanta, Georgia, United States
- 5University of Missouri Kansas City and Mid America Heart Institute, Kansas City, Missouri, United States
- 6Duke University Medical Center, Durham, North Carolina, United States
Robotic PCI entails the use of a joystick to rotate and advance the coronary guidewire. Since guidewire motions frequently involve retracting and rotating the guidewire to facilitate entry into vessel side branches, we sought to evaluate the impact of the first ever automated “rotate on retract (RoR)” robotic coronary guide wire function, which rotates the wire 180 degrees upon retraction of the joystick, on coronary artery wire time efficiency.
Five experienced interventional cardiologists performed a standardized protocol of robotic guidewire advancement, which consisted of steering a guidewire from the tip of the guide catheter into the anterior, then posterior branch of the first OM in a live porcine model using a robotic system (CorPath GRX Vascular Robotics System, Corindus Vascular Robotics, Inc., Waltham, MA). The protocol was first performed using the traditional robotic joystick control, and then by using the joystick with a RoR function activated. Total time to advance the guidewire into both branches by each method was recorded and compared using chi square analysis.
Wiring times with and without RoR are summarized in Table 1. In each case, a reduction in wiring time was observed when the operator used the RoR function. Overall, RoR was associated with significantly faster wiring times and reduced variability (without ROR 48±21 sec; with ROR 20±8 sec, p=0.03). Use of RoR resulted in an observed 53±23% reduction in wiring time.
|User #||Without ROR||With ROR||Percent Change|
|Mean ± SD||48±21||20±8*||-53±23%|
* P-value = 0.03
To our knowledge the present study is the first to investigate an advanced wiring function (RoR) in robotic PCI. The use of ROR was associated with significantly reduced wiring time and less variability between operators as compared with the older robotic-PCI method. RoR might reduce the time required to cross coronary lesions and ultimately improve procedural efficiency and consistency.
OTHER: Pre-Clinical/First In-Human Studies