Planned Robotic Chronic Total Occlusion Percutaneous Coronary Intervention: Feasibility Report

摘要

BACKGROUND: Complex robotic percutaneous coronary intervention (R-PCI) is technically possible and leads to clinically comparable outcomes compared with the manual approach. However, there are limited data on the feasibility of chronic total occlusion (CTO) revascularization via the R-PCI approach. METHODS: Ten consecutive patients undergoing R-PCI for a coronary CTO at a single tertiary academic center were analyzed. The PRECISION, PRECISION GRX, and PROGRESS CTO registries were utilized for data collection with regard to procedural/clinical details and results. RESULTS: Technical success, defined as successful CTO revascularization with full or partial robotic support, occurred in 7 of 10 patients. There were no periprocedural major adverse cardiac events. Average J-CTO score was 2; all procedures were performed from an antegrade approach. The time from robotic wire manipulation to completion of procedure regardless of method averaged 55.1 minutes; average fluoroscopy time was 29.9 minutes. CONCLUSIONS: CTO revascularization via a robotic approach is feasible. Technical success may be best predicted by those patients with low J-CTO scores and lesions amenable to antegrade wire escalation technique. Given the potential benefits to both operators and patients, further research is warranted.