Outcomes of Robotically Assisted Versus Manual Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Objective. We performed a systematic review and meta-analysis of existing studies from the literature comparing robotically assisted (RA) percutaneous coronary intervention (PCI) to manual PCI (M-PCI). Background. RA-PCI is a novel technology that allows the operator to perform PCI from a shielded cockpit using a remote-control module. Methods. MEDLINE/PubMed, EM BASE, and Google Scholar were queried from inception until May 31, 2018 for relevant studies comparing clinical outcomes between RA-PCI and M-PCI. The random-effects model was utilized to compute the summary effect size. Results. Of 2050 retrieved citations, five studies were included, with a total of 148 patients in the RA-PCI arms and 493 patients in the M-PCI control arms. Lower operator radiation exposure was observed with RA-PCI compared with M-PCI. There were no statistically significant differences in total stents per case, PCI time, fluoroscopy time, or procedural success rates between the two groups. Conclusions. In carefully selected patients, RA-PCI was associated with reduced operator radiation exposure compared with M-PCI, but there were no significant differences in procedural success rate, patient radiation exposure, contrast dose, or procedure time.