Giora Weisz, Nathaniel R Smilowitz, D Christopher Metzger, Ronald Caputo, Juan Delgado, J Jeffrey Marshall, George Vetrovec, Mark Reisman, Ron Waksman, Augusto Pichard, Juan F Granada, Jeffrey W Moses, Joseph P Carrozza
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引用次数: 29
摘要
目的:PRECISE多中心研究证明了机器人增强冠状动脉介入治疗(PCI)的安全性和可行性。我们研究了与机器人PCI入路相关的学习曲线。方法:采用CorPath 200机器人系统进行临床指征PCI。每位介入心脏病专家前3例为早期经验病例，后续手术为高级经验病例。我们比较了早期和高级经验病例的手术效率、患者辐射暴露和临床结果。结果:共进行了164例机器人增强PCI手术，其中60例有早期经验。经验丰富的患者手术时间(51.3±25.5 min vs. 42.2±16.4 min, P = 0.008)和透视时间(12.9±7.8 min vs. 10.1±4.8 min, 0.009)短于经验丰富的患者。结论:在完成3例病例后，介入医师能够更快地完成机器人增强PCI，减少辐射，并且不影响安全性。陡峭的学习曲线突出了PCI远程控制机器人技术的容易采用。
The association between experience and proficiency with robotic-enhanced coronary intervention-insights from the PRECISE multi-center study.
Objectives: The PRECISE multi-center study demonstrated the safety and feasibility of robotic-enhanced coronary intervention (PCI). We studied the learning curve associated with the robotic PCI approach.
Methods: The CorPath 200 robotic system was used to perform clinically indicated PCI. The first 3 cases performed by each interventional cardiologist were considered early-experience cases and subsequent procedures were regarded as advanced-experience cases. We compared procedure efficiency, patient radiation exposure, and clinical outcomes in early and advanced-experience cases.
Results: A total of 164 robotic-enhanced PCI procedures were performed, with 60 early-experience cases. Advanced-experience cases were associated with shorter procedure duration (51.3 ± 25.5 min vs. 42.2 ± 16.4 min, P = 0.008) and fluoroscopy time (12.9 ± 7.8 min vs. 10.1 ± 4.8 min, 0.009) as compared to early-experience cases.
Conclusions: After performing 3 cases, interventionalists were able to complete robotic-enhanced PCI faster, with reduced radiation, and without compromising safety. The steep learning curve highlights the easy adoption of remote-control robotic technology for PCI.
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