Robotic-Assisted Percutaneous Coronary Intervention: Final Results of the PRECISION and PRECISION GRX Studies

Background

Robotic percutaneous coronary intervention (R-PCI) reduces occupational hazards for interventional cardiologists. However, there is a lack of clinical data in a large patient cohort. The aims of this study were to evaluate the safety and efficacy of R-PCI with both the first (CorPath 200) and second (CorPath GRX) (Corindus, Siemens Company) generation robotic systems.

Methods

These prospective, multicenter, single-armed studies enrolled patients with symptomatic coronary artery disease from 2013-2017 (PRECISION; CorPath 200) and 2017-2020 (PRECISION GRX; CorPath GRX). The primary outcome measures were clinical success, defined as <30% residual stenosis in the absence of major adverse cardiovascular events, and technical success, defined as clinical success without conversion to manual PCI.

Results

A total of 1734 R-PCI procedures (PRECISION: 754 procedures, 950 lesions; PRECISION GRX: 980 procedures, 1233 lesions) were performed. Clinical (96.9% and 98.1% PRECISION and PRECISION GRX respectively, P = ns) and technical (89.6% and 89.2% PRECISION and PRECISION GRX respectively, P = ns) success rates were similar. Higher clinical success rates were observed in moderate/severe calcification lesions, bifurcation lesions, and long lesions with the second-generation system, and higher technical success rates were observed with the second-generation system in moderate/severe calcification lesions, bifurcation lesions, and angulated lesions.

Conclusions

This multicenter experience with R-PCI demonstrates high clinical and technical success for patients treated with either the first- or second-generation robotic platform. Clinical and technical success rates with the second-generation robotic platform were higher for several complex lesion types. These data support the safety and efficacy of R-PCI in clinical practice.