Robotically-assisted percutaneous coronary intervention: Reasons for partial manual assistance or manual conversion

Cardiovasc Revasc Med. 2018 Jul;19(5 Pt A):526-531. doi: 10.1016/j.carrev.2017.11.003. Epub 2017 Nov 9.


Background: Robotically-assisted percutaneous coronary intervention (R-PCI) is feasible for simple coronary lesions.

Objectives: To determine the frequency and reasons for partial manual assistance or manual conversion during R-PCI in clinical practice.

Methods: The CorPath 200 System (Corindus, Waltham, MA) enables the operator to sit in a radiation-shielded cockpit and remotely control intracoronary devices including guidewires, balloons, and stents. Consecutive R-PCI procedures performed over 18months were analyzed to identify reasons for planned or unplanned manual assistance or manual conversion, and categorized as due to 1) adverse event; 2) technical limitation of the robotic platform; or 3) limited guide catheter/wire support.

Results: During the study period, 108 R-PCI procedures (68.1±11.0years, 77.8% men, 69.4% elective PCI, 78.3% type B2/C lesions, and 50.3% left anterior descending/left main target lesion segment) were performed. High robotic technical success (91.7%) and clinical procedural success (99.1%) were achieved. Twenty procedures (18.5%) required either planned partial manual assistance (3.7%), unplanned partial manual assistance (7.4%), or manual conversion (7.4%). Among these procedures, manual assistance/conversion was required in 3 procedures for an adverse event (15%), 8 for technical limitation of the robotic platform (40%), and 9 for guide catheter/wire support issues (45%).

Conclusions: High clinical success with R-PCI for a complex lesion cohort is possible with only occasional partial manual assistance or manual conversion. The majority of procedures requiring manual assistance/conversion were due to limited guide catheter/wire support or robotic platform limitations, rather than occurrence of adverse events.

Keywords: Complex PCI; Manual assistance; PCI; Robotic; Robotic stenting.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiac Catheters
  • Coronary Angiography
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / instrumentation
  • Percutaneous Coronary Intervention / methods*
  • Product Surveillance, Postmarketing
  • Prospective Studies
  • Registries
  • Risk Factors
  • Robotic Surgical Procedures / adverse effects
  • Robotic Surgical Procedures / instrumentation
  • Robotic Surgical Procedures / methods*
  • Stents
  • Time Factors
  • Treatment Outcome