Robotic PCI compared to standard Manual PCI, which

technology has been utilized in cardiovascular medicine for over a decade, and
over that period, it’s use has been expanded to percutaneous coronary and peripheral
vascular interventions1 .The
feasibility, safety, and high technical success of Robotic assisted PCI for the
treatment of complex coronary disease has been demonstrated in the past2, 3
and the incidence of Longitudinal Geographic miss has also been  found to be significantly lower in robotically
assisted PCI compared to standard Manual PCI, which allows more
accurate lesion length measurement, precise stent placement, and better long-term
clinical outcomes through reduction in Major adverse cardiovascular outcomes4.The
utility and  feasibility of performing robotically assisted
unprotected left main PCI with or without hemodynamic support has also been
demonstrated5. Robotically assisted PCI also
significantly reduces operator exposure to harmful ionizing radiation without a
detrimental effect on procedural success or clinical efficacy, In addition to
the intuitive benefit of alleviating the risk of orthopedic injuries faced by
interventional operators1.


Laser atherectomy is an adjunctive modality
that has been utilized in peripheral as well as coronary lesions. The use of
excimer laser atherectomy has been shown to be safe and effective for the
revascularization of complex, critical de novo peripheral lesions and offers
promise in the treatment and prevention of in-stent restenosis6. Excimer coronary
laser atherectomy(ECLA) is among useful debulking technologies in
coronary chronic total occlusion that enable completion of revascularization.
The rate of major complication rates with excimer laser coronary angioplasty was
found to be low in the (PELCA) registries and similar to conventional balloon
angioplasty7. With
regards to the use of Excimer
laser coronary atherectomy in in stent-restenosis lesions, it was demonstrated
to safely and effectively ablate in-stent neointimal tissue. Adjunct PTCA
extrudes neointimal tissue out of the stent and also further expands the stent.
Compared with PTCA, ELCA+PTCA achieves better short-term and, potentially, better
long-term results8.

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