1. One out of two interventionalists has suffered at least one orthopedic injury1
How this impacts your career
Total time in lead can have significant, lasting health impacts. After 21 years in practice, 60% of interventionalists have spine issues.2 Despite the established use of protective lead gear, exposure to radiation can cause serious harm. After just 10-15 years in practice, interventionalists can experience accelerated vascular aging and early atherosclerosis in the carotid vessel.3 Physician protection is urgently needed—not only to protect the health of interventionalists, but also the organizations they serve. One interventional physician generates approximately $2.4 million in annual revenue. If a physician is unable to practice, it costs more than $1 million to replace them.4
It’s time to rethink how to protect our interventionalists. Robotic assistance in the interventional lab can perform as good as or better than other types of PPE in terms of radiation protection while also aiding to improve patient outcomes and standardizing procedures. By using a robotic-assisted system during cases, interventionalists can reduce their personal radiation exposure by 95% while being comfortably seated without the need for lead.5
2. More than 2/3 of coronary lesion lengths are inaccurately estimated14
How this impacts your patients
Visual assessment of coronary lesion lengths can lead to suboptimal stenting. In one year, these patients are over two times as likely to need a repeat procedure on the same vessel. And in three years, these same patients are three times as likely to have a myocardial infarction.14
With robotic-assisted interventions, you can measure anatomy with sub-millimeter accuracy and position stents with movements as small as one millimeter, which can help reduce the incidence of longitudinal geographic miss and improve patient outcomes. In addition, robotic systems fix devices in place during positioning to help ensure the right stent is in the right place.
3. 74% of patients would consider robotic surgery12
How this impacts your facility’s reputation
Patient expectation in health care continues to increase as they seek good health outcomes, mitigation of risks and side effects, and personalized treatment.
Many providers are listening: About 50% of PCIs, for example, are performed via radial access in the U.S.13 While radial access can be more challenging for physicians, it can provide important patient benefits and contribute to reduced complication rates.
Beyond human clinical expertise, patients seek providers that offer innovative procedures and integrate the latest technological advancements, which can significantly contribute to good health outcomes.
Here, robotic-assisted interventions can help you overcome the clinical and ergonomic challenges of left radial access, while reducing major bleeding and vascular complications and supporting faster ambulation and discharge for patients. Also, robotic assistance can be a differentiator for an organization, potentially leading to an enhanced reputation among patients and the scientific community. Providers that have robotic-assisted technology may be able to provide better outcomes, treat additional patients, and attract and retain top cardiology talent.
4. Interventionalists can encounter problems when treating complex coronary lesions15
How this impacts your organization
Strategies to reduce variability across interventionalists - and facilities - can be essential to improving patient outcomes and reducing risks. Complex PCIs can take more than 2 hours with a large percentage of that time devoted to wire manipulation.16 And, longer procedures can mean increased contrast and radiation dose for patients.
Robotically assisted wire and device manipulation including automated movements can increase precision and reduce variability across interventionalists and facilities. With faster lesion crossing and easier maneuvering, interventionalists can improve procedural standardization while increasing procedural efficiency and mitigating risks.
5. Only 11% of the U.S. physicians work in rural areas, although 20% of the U.S. population lives in rural areas6
How this impacts staffing and patient access to care
Demand for healthcare is high in rural areas. 18% of the population in rural areas is 65 years and older. In urban areas it is only 12%. Rural areas have higher rates of several risk factors and conditions, including risk factors for coronary artery disease such as, diabetes, smoking and obesity.11 At the same time, healthcare is short in supply in rural areas. “Patients have to travel 70 miles to see a physician at the nearest hospital and often even farther.”11 In urban areas 31.2 physicians serve 10,000 people, in rural areas its 13.1 physicians only. For specialists the numbers are even more dramatic – in urban areas 26.3 specialists serve 10,000 people, in rural areas its 3 specialists only.12 By 2025, there will be a projected deficit of 7,080 cardiologists (including interventional cardiologists) in the U.S.13 and experts predict cardiologist shortages to be more acute in rural areas,14 with approximately 56% of patients in remote areas worldwide already lacking access to care today.15 As urbanization continues and the population ages, providers will need strategies that meet the demand for high-quality care in rural areas.
Remote, robotic-assisted interventions16 could help in the future to improve access to care and curb the impact of a physician shortage in rural areas. Providers who are prepared to perform remote interventions may offer much needed treatments to patients regardless of physical location and their specialized experts can devote more time to complex cases.
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Andrassi M. G. et al. Occupational Health Risks in Cardiac Catheterization Laboratory Workers, Circulation: Cardiovascular Interventions. 2016;9:e003273 (2016)
Dehmer G. et al. Occupational Hazards for Interventional Cardiologists, The Society for Cardiovascular Angiography and Interventions, 68 Catheterization and Cardiovascular Interventions 974, 975 (2006)
Andreassi, M.G. et al. Subclinical Carotid Atherosclerosis and Early Vascular Aging From Long-Term Low Dose Ionizing Radiation Exposure. J Am Coll Cardiol Intv. 2015;8(4):616-6271 (2015)
Weisz G, et al. Safety and Feasibility of Robotic Percutaneous Coronary Intervention: PRECISE Study. J American College of Cardiol, 2013, Vol 61, No. 15: 1596-1600 (2013)
Peter Jaret “Attracting the next generation of physicians to rural medicine”, AAMC Feb. 2020 (https://www.aamc.org/news-insights/attracting-next-generation-physicians-rural-medicine#:~:text=Of%20the%20more%20than%207%2C200,physicians%20practice%20in%20such%20areas.&text=As%20many%20rural%20physicians%20near,may%20be%20practicing%20by%202030)
The National Rural Health Association https://www.ruralhealthweb.org
U.S Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. National and Regional Projections of Supply and Demand for Internal Medicine Subspeciality Practitioners, 2013-2025
Gruca T S, et al. Providing Cardiology Care in Rural Areas Through Visiting Consultant Clinics, J Am Heart Assoc. 2016 Jul; 5(7): e002909 (2016)
Remote capabilities are currently under development; it is not for sale. Its future availability cannot be guaranteed.
Costa M A, Impact of stent deployment procedural factors on long-term effectiveness and safety of sirolimus-eluting stents (final results of the multicenter prospective STLLR trial), American Journal of Cardiology 2008:10(12):1704-1711 (2008)
Fanaroff A C et al, Outcomes of PCI in Relation to Procedural Characteristics and Operator Volumes in the United States, J Am Coll Cardiol. 2017 Jun 20;69(24):2913-2924. (2017)
Salisbury A C, et al. In-Hospital Costs and Costs of Complications of Chronic Total Occlusion Angioplasty: Insights From the OPEN-CTO Registry, J Am Coll Cardiol Intv. 2019 Feb, 12 (4) 323–331 (2019)