SCAI 2017: Robotic PCI highly successful with transradial, transfemoral access

The May 12 late-breaking clinical trial at the Society for Cardiovascular Angiography and Interventions (SCAI) 2017 Scientific Sessions in New Orleans compared femoral and radial robotic percutaneous coronary intervention (PCI) procedures.

Ehtisham Mahmud, MD, the study’s lead author with the University of California, San Diego School of Medicine, presented the results of the PRECISION trial that collected data included 16 sites featuring the CorPath 200 System, the first FDA-approved robotic technology to remotely control coronary guidewires and stents for PCI patients.

“This is the first time we are demonstrating that the robotic system can be used, with either a radial or femoral approach, with high clinical and technical success in multiple sites with multiple operators,” said Mahmud, MD.

The study included 754 robotic PCI procedures using transradial access (TRA) and 298 transfemoral access (TFA) procedures. Both were successful in technically (88.6 percent for TRA and 82.4 perfect for TFA) and clinically (98.9 percent for TRA and 94.9 TFA).

Unrelated to the robotic system, 18 serious adverse events took place, with six being major cardiac events in the TFA group.

“In unadjusted analysis, it appears that there may be slightly better outcomes with the radial approach,” said Mahmud. “However, there were significant baseline demographic and angiographic differences between the two groups with radial access patients being less complicated. After conducting a propensity score matched analysis, no differences were observed between the two approaches. Although, there was a slightly superior clinical success with radial access, it was likely the result of patient selection.”

According to the research group, the data shows that robotic PCI in clinical practice via the radial or femoral approach is feasible and effective.