Robot-assisted versus manual percutaneous vascular interventions across vascular territories: a systematic review and meta-analysis.

Xiaotian Wu; Shuaiwei Guo; Yi Zhang; Xiao Zhang; Yingfeng Li; Xinjie Lin; Shengyan Cui; Zixuan Xing; Linsen Zhang; Xiangyu Li; Yixin Sun; Jichang Luo; Mingqian Qin; Liqun Jiao; Shiqi Liu; Tao Wang

doi:10.1007/s11701-026-03930-4

PubMed · 42704529

Robot-assisted versus manual percutaneous vascular interventions across vascular territories: a systematic review and meta-analysis.

Xiaotian Wu·Shuaiwei Guo·Yi Zhang·Xiao Zhang·Yingfeng Li·Xinjie Lin·Shengyan Cui·Zixuan Xing·Linsen Zhang·Xiangyu Li·Yixin Sun·Jichang Luo·Mingqian Qin·Liqun Jiao·Shiqi Liu·Tao Wang

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Abstract

Robot-assisted percutaneous vascular intervention (R-PVI) has expanded beyond coronary procedures, but previous reviews were largely coronary-focused and observational. Recent randomized controlled trials (RCTs) warrant broader reassessment of R-PVI versus manual percutaneous vascular intervention (M-PVI) across vascular territories. PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from database inception to January 31, 2026, following PRISMA guidelines. RCTs and observational studies including ≥10 adult patients in total were eligible. Comparative studies informed primary analyses, while single-arm studies provided supportive evidence. Primary outcomes were clinical success rate and major adverse cardiovascular/cerebrovascular events (MACE) rate. Secondary outcomes included mortality rate, technical success rate, procedural time metrics, contrast volume, and radiation exposure. Random-effects models were used. Forty studies were included: 3 RCTs, 10 comparative observational studies, and 27 single-arm observational studies, comprising 3,870 patients undergoing R-PVI and 1,142 undergoing M-PVI. Comparative analyses showed similar clinical success rates (RR 1.00, P = 0.46), MACE rates (RR 0.72, P = 0.43), and mortality. Single-arm pooled estimates for clinical and technical success were 98.76% and 96.09%, respectively. R-PVI prolonged total procedure time overall (MD 15.92 min, P = 0.01), with consistent increases in the neurovascular, RCT, and non-RCT subgroups. Fluoroscopy time was also longer (MD 1.91 min, P = 0.04), mainly in the RCT subgroup (MD 2.83 min, P = 0.001). In contrast, intravascular intervention time was unchanged overall and in RCTs, but was prolonged in non-RCTs (MD 8.72 min, P = 0.006). Operator radiation exposure was markedly reduced (MD -33.97 μSv, P < 0.001), whereas patient radiation exposure and contrast volume were similar. R-PVI appears feasible and safe across selected vascular procedures. Its clearest benefit is reduced operator radiation exposure, whereas lower whole-procedure efficiency remains its main limitation.

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Humans Robotic Surgical Procedures Vascular Surgical Procedures Randomized Controlled Trials as Topic Treatment Outcome Observational Studies as Topic Clinical success Manual percutaneous vascular intervention Meta-analysis Robot-assisted percutaneous vascular intervention (R-PVI)Journal Article Systematic Review Meta-Analysis Comparative Study Review

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Xiaotian Wu, Shuaiwei Guo, Yi Zhang, Xiao Zhang, Yingfeng Li, Xinjie Lin, Shengyan Cui, Zixuan Xing, Linsen Zhang, Xiangyu Li, Yixin Sun, Jichang Luo, Mingqian Qin, Liqun Jiao, Shiqi Liu, Tao Wang. 2026-09-07. Robot-assisted versus manual percutaneous vascular interventions across vascular territories: a systematic review and meta-analysis.. https://doi.org/10.1007/s11701-026-03930-4

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Comparative Study subject Humans subject Journal Article subject Journal Article; Systematic Review; Meta-Analysis; Comparative Study; Review resource Meta-Analysis subject Observational Studies as Topic subject Systematic reviews study

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