Robotic Percutaneous Coronary Intervention: Assessing Longitudinal Geographic Miss

Background: Inaccurate measurement of lesion length during percutaneous coronary intervention (PCI) increases the risk of restenosis and poor clinical outcomes. Methods: Two interventional cardiologists evaluated angiographic images and made visual estimates of target lesion length and stent length selection. A 2 mm stent overlap of both the proximal and distal lesion edges was considered to be optimal. The target lesion was also assessed for lesion length using the millimetre controls of the CorPath®GRX system (Siemens Healthineers AG, formerly Corindus). Measurements for 10 lesions (randomly selected) were repeated to assess inter-observer variability. The primary endpoint was longitudinal geographic miss (LGM), defined as an absolute difference of 2 mm or more between visual and vascular robotics measurements. Results: A total of 21 lesions in 19 patients were evaluated. LGM was detected in 16/21 lesions. Visual lesion length measurements were short for 15 (71%), long for one lesion (5%) and appropriate for five (24%). Stent or drug-coated balloon length selections were short for 15 lesions and appropriate for six. Conclusion: The CorPath GRX robotic PCI system increases the accuracy of lesion length evaluation and stent length selection compared with visual estimation.