The COVID-19 pandemic has placed unprecedented strain on the US healthcare system, forcing innovation to move at an accelerated pace and resulting in new applications for existing technologies and some entirely new solutions for patient care. It especially impacted hospitals who were inundated with COVID-19 patients, shining a light on the need to offer treatment options outside of the hospital setting. The CorPath® GRX System is one example of an existing technology that has helped cardiologists treat their patients in new and innovative ways.
Recently, the system was used for the first-ever outpatient robotic PCI at Cardiovascular Surgical Suites in Coral Springs, FL, an ambulatory surgery center (ASC) that is focused on providing same-day surgical care, including diagnostic and interventional procedures. We sat down with interventional cardiologist Adam Bierzynski, MD, who performed the procedure, and Oleg Gutnik, MD, Founder and CEO of Cardiovascular Surgical Suites, to learn about robotic PCI in the ASC setting.
Q: Why is an ASC a suitable location for PCI?
Dr. Bierzynski: For cardiology patients in need of non-emergency PCIs, such as those without unstable coronary disease, an ASC is an excellent option. The added precision and accuracy of robotic-assisted procedures further enhances the safety, accuracy and convenience ASCs offer.
Dr. Gutnik: The procedure itself, regardless of whether it’s done in a hospital or at an ASC, is technically the same. Similarly, when it comes to utilizing CorPath GRX, it works the same way in either facility. However, ASCs offer some other benefits that may appeal to patients. For example, they are better able to control the quality of their services, provide greater personal attention, and deliver care at lower costs. These factors can make them a more suitable choice for some people seeking specific procedures, like PCIs.
Q: Why do you believe ASCs are becoming more popular among patients and providers?
Dr. Bierzynski: The outpatient setting can be very appealing for patients who want to avoid hospitals in COVID-19 hotspots. All ASC patients are scheduled and pre-screened. That means there is little risk of exposure to other patients that potentially have COVID or other diseases. Additionally, outpatient procedures performed at an ASC allow patients to return home the same day. For this robotic case, the patient was released just hours after the procedure.
Dr. Gutnik: There is a trend in the medical industry toward the increasing utilization of ASCs. Some research estimates that ASCs will be performing between 30% and 35% of cardiac procedures by the mid-2020s. Part of this is due to financial reasons – CMS did not previously approve outpatient PCIs for patients enrolled in Medicare. Beginning January 1, 2020, the procedure was approved for reimbursement. As elective procedures resume, Cardiovascular Surgical Suites is poised to serve local patients with the best care possible.
Q: What are the key advantages of robotic PCI over manual procedures?
Dr. Bierzynski: In the outpatient setting, safety and precision is everything. The precise control and millimeter-measurement capability the robot provides is comforting to the operator, as you can feel confident you will cover the entire lesion or avoid a side branch. It allows me to focus more on the work I’m doing and trust that my patients will remain safe.
Another thing that is particularly appealing to me about robotic PCI is the benefit it offers when it comes to physician radiation. The fact that the doctor can be outside of the lab operating the robot really makes an impact when it comes to exposure. Significantly reducing radiation exposure for each case, over the course of your career, makes a huge difference to your individual health risk.
Another aspect that drew me to robotic PCI is the potential for the technology to power remote procedures. I was raised on the island of Grenada, and the lack of access to medical care there inspired me to seek out new treatment modalities. Because Grenada doesn’t have a cardiac catheterization lab, most patients suffering from acute cardiac issues are given thrombolytics and hope that they reperfuse – only those who have the means can be airlifted to Trinidad to receive the care that they need. That background and the capabilities offered by CorPath GRX make me excited for the possibility that at some point in the near future, I could perform life-saving procedures from remote locations for underserved areas or even overseas countries with limited resources like Grenada.
This ASC-based, robotic procedure marked my first time utilizing the robot after receiving intensive training, and my first attempt went seamlessly. That speaks volumes about the ease of use of the robot and how quickly physicians can develop the skills needed to use it.
Dr. Gutnik: In the medical field, innovation and technology can often be used to improve patient care. I am a gynecologist by trade, and my specialty was significantly improved by the introduction of laparoscopic surgery. The same goes for cardiology – the physicians we are working with can see that like any other specialty, utilizing technology, and specifically robotics, can help provide patients with the best care. The robotic technology allows physicians to move the catheter with extreme precision, ensuring the procedure is done correctly on the first try, and it limits our exposure to the harmful radiation associated with PCI and other cardiovascular procedures.
Overall, we are very proud to be part of this team and are proud to be users of this technology. We’re humbled to be the first ASC to specialize in cardiovascular work and to allow physicians to work with patients using endovascular robotics.