Coronary artery disease is caused by a narrowing of the coronary arteries due to a build-up of calcified deposits, or plaque, on the vessel walls. This process is called atherosclerosis.
Two main arteries supply blood to the heart – the left coronary artery (which in turn splits into two smaller arteries, the left anterior descending and the left circumflex artery), and the right coronary artery. These arteries are the main blood vessels that ensure the heart muscle gets enough oxygen. There is little communication between the two. As a result, the occlusion (blocking) of these vessels rapidly causes necrosis (tissue death) of the heart muscle. This is called myocardial infarction.
Myocardial infarction is the leading cause of death worldwide.
Time is a significant variable in treating coronary artery disease.
A number of factors increase the risk of developing coronary artery disease:
As coronary artery disease develops slowly, symptoms appear at a late stage, when the narrowing has already reached a certain level.
One of the first symptoms is a feeling of ‘tightness’ in the chest on exertion (walking quickly, running, etc.), called angina. This takes the form of intense pain deep in the chest, and is a sign that the heart muscle is not getting enough oxygen.
It may also be felt after meals, when digesting food, or when resting at night. Often, it feels like this pain is radiating into the left arm. It can also radiate into the neck, the lower jaw, the right arm, or into the back and stomach.
This intervention is carried out following a coronary angiogram, which determines the area to be treated and the degree of stenosis requiring revascularization.
The R-OneTM robotic platform was designed to improve operation conditions during PCI’s, particularly phyisician comfort and safety.
It is a minimally invasive procedure, during which a catheter is inserted into the body at the wrist (radial artery) or the groin (femoral artery). This catheter travels up the peripheral blood vessels to the start of the blocked coronary artery.
A contrast medium may be injected into the catheter to make the progression of the instruments visible on x-ray imaging monitors.
Following this, a guidewire is inserted into the catheter and placed in the blocked artery. It is moved to the lesion by the cardiologist, who is seated at the radioprotected control unit.
Subsequently, a stent-carrying balloon, previously mounted on the guidewire, then moves to the lesion to be treated and is inflated, so that the lumen of the artery (the space inside the vessel) is restored and the blood circulation through this zone is improved.
The balloon is then deflated so the device can be removed, leaving the stent in place.
All these actions are carried out by the cardiologist from the robotic platform’s radioprotected control unit.
Peripheral artery disease (PAD), particularly in the legs, is caused by the narrowing of the arteries supplying blood to the body (other than those that supply the heart).
If it is not treated rapidly and measures are not taken to improve the patient’s lifestyle (stopping smoking, regular physical exercise, balanced diet, etc.), it can cause differing levels of disability and lead to amputation.
PAD can be divided into four stages:
As with coronary artery disease, peripheral artery disease can be treated with angioplasty.
This consists of dilating the narrowed arteries using an instrument called a balloon to revascularize the blocked area. A stent (a small spring-shaped metal implant) may be inserted to maintain the blood flow after dilatation.
This is a minimally invasive procedure carried out under local anesthetic.
R-oneTM, the first medical robot developed by Robocath, was designed to meet the needs of interventional cardiology.
The next generation of robotics will also handle peripheral revascularizations, such as peripheral artery disease, with a more or less identical treatment protocol to revascularization of the heart muscle.
Robotic assistance will ensure surgeon comfort and safety during procedures, offering extreme precision when using instruments.
A stroke can be caused by the obstruction or rupture of a blood vessel supplying the brain. In most cases, a vessel is obstructed. This is called an ischemic stroke. A ruptured vessel is called a hemorrhagic stroke.
A stroke represents an extreme emergency, as it can have severe consequences. Time is a key factor. The quicker a stroke is treated, the lower the risk of serious adverse effects.
A stroke can manifest as partial or total paralysis of one or more limbs, reduced feeling or numbness affecting the face, speech difficulty (incoherent speech), balance and memory issues, and vision problems.
In the case of cerebral infarction, the treatment consists of unblocking the obstructed vessel as quickly as possible. Two methods are currently used to do this:
1 Mechanical thrombectomy in acute ischemic strokeL. Derex, T.-H. Cho, 2017
The medical robot R-One has been created for treating coronary artery disease, Robocath has started R&D work with a view to designing a robotic assistance platform for mechanical thrombectomy.
In addition to the benefits of this new treatment, robotic assistance will enable surgeons to carry out procedures under better conditions (complete protection from x-rays, precise navigation, etc.).