Resource Utilization During Elective Robotic-Assisted Percutaneous Coronary Intervention

Objective. Robotic percutaneous coronary intervention (R-PCI) results in comparable outcomes to manual PCI in the treatment of obstructive coronary artery disease (CAD). The objective of this study is to evaluate the cost and resource utilization of R-PCI compared with manual PCI. Methods. Consecutive patients with CAD undergoing elective R-PCI or manual PCI over an 18-month period by a single operator were included. Procedure-related costs and resource utilization were analyzed and propensity adjusted to account for differences in baseline demographic and lesion characteristics. Results. A total of 164 patients (mean age, 68.9 +/- 10.8 years; 81% men) underwent R-PCI (n = 56) or manual PCI (n = 108). The R-PCI group demonstrated higher Syntax scores (17.8 +/- 12.9% vs 11.8 +/- 7.7%; P<.01) and a greater proportion of type B2/C lesions (89.3% vs 69.4%; P<.01). R-PCI was associated with higher unadjusted costs of total hospitalization ($8219.90 +/- 336.60 vs $7268.50 +/- 220.10; P=.02) and direct supplies ($4711.10 +/- 239.90 vs $3809.40 +/- 166.80; P<.01). Following propensity-matched analysis, R-PCI was associated with higher direct supply costs alone, without a significant difference in total hospitalization or catheterization laboratory cost. Furthermore, R-PCI demonstrated similar fluoroscopy time, procedural time, and total number of stents, but with a lower volume of contrast (182.7 +/- 8.9 mL vs 206.8 +/- 9.0 mL; P=.04). Conclusions. Costs and resources associated with R-PCI are comparable with manual PCI, with an expected increase in direct supply costs attributed to single-use robotic components.