Robotic Interventions

West Tennesseans are the first in the state to have access to the latest technology for angioplasty, Robotic PCI

JMCGH, only hospital in state offering CorPath GRX System for coronary artery disease

Since the introduction of percutaneous coronary intervention 40 years ago, there has been an astonishing amount of advancement in the technology and devices used in the procedure and robotics are a big part of the trend. Today, many procedures that were once highly invasive are now being performed via minimally invasive techniques, with the added benefit of robotic precision and radiation protection. And West Tennessee is the first in the state to have this level of technology.

Percutaneous coronary intervention (PCI) fixes blockages in heart arteries without the need for open surgery using catheters inserted through the blood vessels. Robotic-assisted PCI Heart Stent placement is commonly known as robotic PCI. Robotic-assisted PCI is a revolutionary new technology that allows a cardiologist to use a robotic console to navigate the heart arteries and place stents inside the blocked arteries to fix heart blockages with the potential for incredible precision.

Jackson-Madison County General Hospital, is the only hospital in Tennessee to offer the CorPath GRX System for the treatment of coronary artery disease. The vascular robotic-assisted system offers interventional cardiologists robotic precision when controlling guide catheters, guidewires, balloons and stents during CorPath Robotic Angioplasty. Currently the hospital has two units in operation.

Cardiologist John Baker, MD, of the Jackson Clinic, PC was instrumental in the technology coming to Jackson. "The equipment for robotic PCI has been present for seven to eight years, but recent advances in technology caused me to develop an increased interest," he said. "The area that was of most interest was the ability to deliver increased precision over the manual techniques we already have been using. Dr. Miller and I traveled to New York Presbyterian Hospital/Columbia University to learn about and evaluate the technology. We realized this was something that could be beneficial to patients in West Tennessee. Our training included instruction on the use of the equipment as well as observing live cases. We also traveled to a research facility in upstate New York, where we were able to obtain hands-on training with the device in an animal lab."

The CorPath System is the first FDA-cleared robotic platform designed for interventional cardiologists. It is composed of two functional subunits: the bedside unit and the remote physician workspace. The bedside unit consists of the articulated arm, the robotic drive, and a single-use cassette in which devices including wires, balloons, and stents are loaded. The remote workspace consists of the interventional cockpit, which is surrounded by a radiation shield and houses the control console, angiographic monitors, hemodynamic monitors, and the x-ray foot pedal.

In robotic PCI, a cardiologist sits at a robotic console and uses the controls to manipulate the wires to incredible degrees of precision allowing them to be passed into the chosen artery and through the area of blockage. The system allows the operator to control and manipulate guide wires, balloons, and stents using a set of joysticks and touch screens while fluoroscopy provides image guidance. Axial and rotational motion are achieved by a mechanical transmission module. The balloon or stent can be guided both in a continuous motion using the joystick and in discrete highly sensitive small steps using the touch screen. The major benefits of robot-assisted PCI include improved operator safety and procedural precision, increased accuracy in stent selection and improved patient outcomes.

"The procedure is performed in the cath lab," said Jeff Young, executive director of West Tennessee Heart and Vascular Center. "The system takes images at the cath table and sends them to the cardiologist who is in the cockpit. There are three screens that have real time images and still images. Tools built into the system and software allow those images to be layered to allow for more accurate marking of vessels and to set targets for advancing wires and stents."

"The procedure is possible on virtually any type of patient. Benefits to the patient are increased precision with which guidewires, balloon dilation catheters and stents may be placed with robotic control," said Baker. "The physician however, has the benefit of being removed from the x-ray source resulting in reduced exposure to radiation. The potential for orthopedic injury to the physician is decreased because a lead apron is not required while doing the robotic procedure."

Emily Garner, RN

"This raises our program to a whole other level in technological advancements. To be the first and only hospital in the state to offer this shows our commitment to giving the best care possible to our patients," said Emily Garner, RN, clinical manager for West Tennessee Heart and Vascular Center. "This is cutting edge technology that not only offers exact and precise treatment for the patient, but also helps prevent future negative effects to our physicians."


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