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Technology Improving Access to Care

Posted by Tal Wenderow
March 27, 2014
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Imagine you live in a rural area of the United States when you suddenly begin experiencing symptoms of a heart attack caused by a blockage in one of your arteries. Now imagine that the nearest facility that can successfully perform the procedure to open your blocked artery is over 200 miles away. Unfortunately, this is the situation for many Americans.

Currently in the United States only 39% of hospitals have the capability to perform percutaneous coronary interventions (PCI). In cases of ST-elevated myocardial infarction (STEMI, or severe heart attack), the time between when a patient presents with symptoms and when they are treated is crucial. Simply put, time is muscle: Every 10 minute delay to PCI results in a 1% change in mortality.1 While hospitals that are capable of performing PCI have seen a dramatic decrease in what is called “door-to-balloon” time, fewer patients from referring hospitals with no capability to perform PCI are treated within the 90 minute window set forth as the standard by the American College of Cardiology.2

As part of ongoing research to improve the availability of world class care to remote rural areas of the United States, Corindus has partnered with Sanford Health and The Leona M. and Harry B. Helmsley Charitable Trust to launch a technical feasibility investigation for remote robotic PCI with the CorPath Vascular Robotic System. Today, robotics is empowering interventional cardiologists in cath labs across the US with precise sub-millimeter measurement and 1mm advancement accuracy. By optimizing stent selection and positioning, CorPath gives physicians the tools to use the fewest stents per lesion which has been shown to improve procedural outcomes.3

The goal of the remote robotics program is to empower an interventional cardiologist using CorPath to robotically control the movement of interventional devices at a remote facility. This technology could even be applied to a network of hospitals that are committed to providing access to high-quality care across their hospitals or even a hospital 60 miles away from the main hospital that is currently not capable of performing PCI. For Sanford, that means not only providing access to life-saving angioplasty, but delivering the high level of care their patients experience when they receive a CorPath Robotic Angioplasty at their centers in Sioux Falls and Aberdeen, South Dakota.

While this technology has the potential to drastically improve outcomes for the population of patients living in rural America, the first step will be to understand what is needed to ensure the program is a success. Physician training will be crucial to the realization of a remote robotics program. Once we understand the workflow between the physician and the rural site, we will understand how to design the product and how to train the operators.

Today, robotic-assisted PCI is becoming the standard of care at cath labs across the United States. By integrating the precision of robotics with vision of Corindus and Sanford Health, this technology and the live-saving care of expert physicians will be available in even the most remote areas in the years to come.

  1. Nallamothu BK et al, AM Journal Cardiology 2003
  2. J Am Coll Cardiol. 2011;57(3):272-279
  3. Finn AV, Kolodgie FD, Harned J, et. al. Differential response of delayed healing and persistent inflammation at sites of overlapping sirolimus- or paclitaxel-eluting stents. Circulation. 2005;112:270-278
  
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