Robotic technology applied to carotid stenosis operations

At Maria Cecilia Hospital, part of GVM Care & Research, an operation for the insertion of a carotid stent with the use of a robot took place for the first time outside the USA: a robotic guide system that maximizes the operator’s precision in the field of vascular intervention and in particular in the insertion and positioning of catheters for the application of stents.

At Maria Cecilia Hospital we use this technology mainly for complex coronary interventions – explains Dr. Paolo Sbarzaglia, Interventional Cardiologist of the  Diagnostic and Interventional Cardio-Angiology  Department, directed by Dr. Fausto Castriota -. Since the devices, stents and catheters used for coronary intervention are similar to those used for carotid procedures, we evaluated the possibility of being able to intervene with a robotic system to obtain greater precision in treating a stenosis of the carotid artery. This is the first operation outside the US performed with the robotic system on the carotid artery“.

The patient, a 76-year-old Italian, had been operated on in the past for a carotid angioplasty due to atherosclerosis, a pathology characterized by the accumulation of plaques on the internal walls of the vessels that prevent the correct flow of blood. At the last periodic meeting of the patient with the specialist, an Angio CT of the supraortic trunks presented an image compatible with a recurrence of the pathology at the level of the carotid, in the vicinity of the stent placed during the previous procedure (which took place over 6 years ago).

Carotid atherosclerosis tends to manifest itself again after years, despite perfectly successful interventions – comments Dr. Sbarzaglia -. Hence the importance of periodic follow-ups for these patients. In fact, the CT performed at Maria Cecilia Hospital showed the presence of a very important stenosis of the right carotid inside the old stent that was previously implanted. Only during the procedure, the angiography confirmed that the anatomy of the stenosis was suitable to be treated with the aid of the robotic system for a minimally invasive percutaneous angioplasty“.

The operation made it possible to restore the normal lumen of the carotid artery and to revascularize the brain in an optimal manner. The patient was discharged after just 2 days of hospitalization, returning home with an indication for antiplatelet therapy.

In the future, the use of this cutting-edge technology could also allow remote procedures to be performed: “Thanks to the use of new, increasingly high-performance connections, it will be possible to use robotic systems remotely, many kilometers away, allowing us to intervene promptly even from places far from hospitals”, adds Dr. Sbarzaglia.

Presented at the congress of the Italian Society of Interventional Cardiology, the Corindus CorPath GRX robotic system allows to perform automated movements and more accurate anatomical measurements: an important advantage for the patient who thus benefits from an even higher level of safety, precision and reliability. The system also makes it possible to optimize procedures and reduce the insertion time of guides and catheters by 53%.

The advantages of being operated with the support of a robotic system are also in terms of the post-operative recovery: the support of robotics allows an even more appropriate choice of the length of the stent, thus halving the need for a re-operation of revascularization within a year and reducing by a third the likelihood of a heart attack within three years.

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