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Robotics Make Coronary Angioplasty More Precise

At a Glance

As you know, percutaneous coronary intervention (PCI) or coronary angioplasty is the best option to restore blood flow to the heart. Now, robotics and other innovations are making this procedure even safer and easier. Kanwar Singh, MD, an interventional cardiologist at UVA Heart and Vascular Center and a nationally-recognized expert on robotic coronary angioplasty, explains more about this important advance.

How have robotics improved the way doctors at UVA perform coronary angioplasties?
The robot allows for improvements in precision and measuring that really couldn’t be performed before. It can advance and retract devices in increments less than, or equal to, one millimeter. So with the push of a button, or the deflection of a joystick, we can deliver in a very precise way this equipment that’s so key to get exactly right.

It also removes the radiation risk and ergonomic discomfort involved in performing coronary angioplasties. Using the robot allows us to remove some of that operator-fatigue aspect, which is subtle but is certainly important. Now, the care provider can control the procedure from a comfortable cockpit with optimal viewing angles and improved definition, so we can take the best care of the patient.

When did UVA start using robotics for opening clogged arteries?
In 2014, UVA became one of the first 25 centers in the world to install a robotic device for performing coronary angioplasties. Most recently, in February 2017, we were one of the first three centers to get the newest generation of the robot when it was redesigned. So we’re truly one of the leading centers in the world with robotic coronary angioplasty. We’ve been holding courses for the past two years for visiting surgeons who are eager to learn techniques and figure out how to adopt a robotic program into current practice. We’re also involved in multiple studies examining ways to improve robotic PCI even further to make it safer and more effective.

What improvements come with the latest technology?
The new robot is just more capable—it’s quicker, more powerful, and more steerable. That’s allowed us to take on cases that, six months ago, we wouldn’t have even considered using the robot for, and also to do more of any given case with the robot. For example, the earlier device could not control the guide catheter, which is kind of like the railroad tracks that everything else is delivered on. During a procedure, with the heart actively beating in the chest, the delicate placement of the catheter can move. Before, if that happened, you would have to convert to a manual procedure. Now the robot can drive the guiding catheter also, which allows us to do more of the work robotically.

 

To refer a patient to the UVA Heart and Vascular Center, call 800.552.3723.