CorPath GRX System

CorPath GRX System is a robotic system developed by Corindus Vascular Robotics for percutaneous coronary interventions.

2023: Discontinuation of production

On May 10, 2023, medical device supplier Siemens Healthineers AG announced the cessation of production of robots for cardiac surgery due to deteriorating financial performance.

Siemens Healthineers, as noted, faced operating losses amid a sharp drop in demand for tests for COVID-19 amid an improved epidemiological situation and easing restrictions imposed in response to the spread of coronavirus infection. In the diagnostics division, revenue is expected to fall by 23% -26% on an annualized basis. At the same time, the company will have to write off €329 million in the robotic endovascular cardiology division: Siemens Healthineers received this business as part of the acquisition of Corindus for €1 billion in 2019.

The use of Corindus robots for cardiac surgeries fell short of our expectations. It will take several years before robotic systems for neurological procedures are ready to enter the market, "said Siemens Healthineers Chief Financial Officer Jochen Schmitz.

Corindus created the CorPath GRX System robotic platform for percutaneous coronary interventions. At the end of 2022, this line of business was renamed Siemens Healthineers Endovascular Robotics. The Corindus takeover was supposed to allow Siemens Healthineers to enter adjacent growing markets with more potential in the future. At the time of the deal, it was said that Corindus's precision robotics platform could transform the healthcare system. However, by the beginning of May 2023, it was not possible to achieve significant success in the relevant segment, so the management decided to curtail the production of cardiac surgery robots.^[1]

2022: Siemens Healthineers robot surgeon begins treating brain aneurysms

On September 12, 2022, the company, Corindus part of the group, Siemens Healthineers spoke about conducting a clinical study on using surgical robot for closure aneurysms in the brain.

According to the company, the CorPath GRX neurovascular system successfully completed 94% of endovascular procedures using a robot, while the surgeon did not have to switch to a manual approach during surgery.

Siemens Healthineers robot surgeon begins treating brain aneurysms

More than 64% of patients experienced complete obliteration of the aneurysm, and 78% showed no clinical symptoms after the procedure. The remaining 22% of patients received a grade of 1 or 2 on the modified Rankin Neurological Disability Scale, the company said in a release, meaning they could continue to care for themselves unassisted and could perform most daily activities.

At the same time, in 95.7% cases, the study met safety targets defined as the absence of blood vessel damage or rupture, and any subsequent coagulation-related disorders within 24 hours of the procedure or after the patient was discharged from the hospital.

{{quote 'Intervention in the neurovascular system requires extreme accuracy to achieve optimal clinical outcomes,' lead study author Michel Piotin, MD, PhD, head of the interventional neuroradiology department at the Rothschild Foundation Hospital in Paris, said in a Siemens release. The results of the study show that the CorPath GRX system helps doctors move effectively in winding and unstable vessels. }} The study included 117 patients from 10 clinical centers in six different countries, having different aneurysm sizes, locations and characteristics.

{{quote 'By implementing robotic platforms in this area, we are paving the way for remote intervention procedures in the future that will enable patient communication with specialized interventionists for treatment, regardless of location,' Raymond Turner, MD, Chief Medical Officer for Neuroendovascular Interventions at Corindus, said in a release^[2] }}

2020

technIQ Automated Feature Suite Announcement

In late December 2020, Corindus, a subsidiary of Siemens Healthineers developing precision vascular robotics, introduced a new set of automated technIQ features for its CorPath GRX system. The new software will empower robotic surgeons with the skills of professional cardiologists.

The new features replicate the practices of highly skilled interventional professionals and are expected to reduce surgery time and make complex procedures on coronary and peripheral vessels more predictable.

These algorithms open up new possibilities for the surgeon during surgery, especially in complex lesions, "said Dr. Jean Fajadet, director of the Department of Interventional Cardiology at Clinique Pasteur. Fayade was the first surgeon to use new algorithms during human coronary artery surgery, significantly reducing the procedure's time.

Corindus has given its robotic surgeons the skills of super-professional cardiologists

CorPath is designed to perform percutaneous coronary intervention and protect physicians from radiation exposure in a catheterization laboratory. Automated functions are four robotic motions that help the surgeon perform complex tasks remotely, taking into account the individual features of the patient's anatomy. In particular, CorPath GRX helps the surgeon cross the affected areas, pass arteries with a winding channel and measure a number of anatomical parameters necessary to select the size of the devices used.

Automating more movements used in cardiovascular intervention will allow doctors to focus on a common treatment strategy and at the same time give them advanced methods of navigating the vasculature, says Wayne Markowitz, executive vice president and head of Corindus[3]

Robotic surgeons start treating brain vessel aneurysm

In mid-March 2020, Canadian surgeons successfully performed surgery for a brain aneurysm using a robotic surgical system for the first time.

The system for robotic surgery is commonly used in cardiovascular surgery, but has been adapted for use in endovascular brain procedures that use microcatheters, conductors and other devices. The system was manufactured by Corindus, acquired by Siemens Healthineers in 2019.

Canadian surgeons successfully perform brain aneurysm surgery with robotic surgical system for the first time

The robotic system adds accuracy to us, "explained the surgeon who performed the operation. - It allows you to more precisely control catheters. In addition, she becomes an additional hand.

The first patient was a 64-year-old woman with an unexploded aneurysm at the base of her skull. Surgeons used a robotic system to install a stent and coils to close the aneurysm. Since robotic operations are performed remotely, surgeons did not have to wear a lead shield, and they could settle in a more convenient position behind the screen.

It is assumed that ultimately this technology will allow for faster emergency operations for patients from remote areas, improving the results of patients who no longer need to be transported.

Due to the low population density, 80 to 90% of people do not have access to this type of treatment in the first hour after an acute cerebrovascular accident, the surgeon explained. - In Canada and the United States, this system will mainly be used to treat strokes. Some countries do not have access to these technologies, so we will also be able to treat patients in other countries if they do not have enough experts.

A multicenter study demonstrating the safety of these procedures is expected to begin soon.^[4]

2019

Cardiologist via the Internet performed the first percutaneous coronary intervention

In late October 2019, Michigan cardiologist Ryan Madder performed the first transcontinental percutaneous coronary intervention in the United States.

Dr. Madder, an interventional cardiologist at Spectrum Health in Grand Rapids, Mich., performed 36 surgeries geographically scattered from San Francisco to New York that same day. To do this, Madder used three types of network connections and the CorPath GRX system with the Corindus remote operations device, developed by Siemens Healthineers.

Michigan cardiologist Ryan Madder performed the first transcontinental percutaneous coronary intervention in the United States

Since robotic system Corindus it can be used to perform endovascular procedures of various localization, it can be used to perform remote coronary interventions, neurovascular interventions in stroke patients, and interventions in patients with peripheral artery disease - all at a distance of up to 3,000 miles, Madder explained.

The procedures were performed over a 5G wireless network, dedicated fiber connections and commercial public networks. While in Waltham, Madder performed procedures with the latest simulators, whereas the patients were in New York City, 200 miles from Waltham, and San Francisco, 3,000 miles away.

The networks provided a low-latency connection and successful remote procedures. The CorPath GRX system allowed Madder to monitor the robot's actions from a remote location in real time. The results will allow interventional cardiologists to use robotic technologies for the safe and effective remote execution of coronary procedures anywhere in the country. This approach will reduce waiting times for surgery and increase access to highly qualified medical care.^[5]

First brain surgery

In mid-November 2019 robot surgeon , the company, Corindus which was bought a few weeks earlier, Siemens performed the first neurosvascular operation. The robot operated under the direction of Dr. Vitor Mendes Pereira, a neurosurgeon and neurorentgenologist at Western Hospital and the Toronto Krembil Brain Institute in. To Canada

The field of neurovascular interventions is changing rapidly, but the task of accessibility of medical care and reducing the timing of treatment is still acute, "explained Corindus CEO Mark Toland. - The introduction of robotic devices for neurovascular operations is the first step towards providing high-quality medical care anywhere in the world. The complex of clinical studies on neurosvascular robotics, along with the training of doctors, will soon allow the deployment of a remote robotic medical care program

Corindus Vascular Robotics Robot Surgeon Performs First Neurosvascular Surgery

The robot's successful operation is a good example of how merging new technologies is changing surgeons "approach to their business. Before the procedure, Dr. Pereira rehearsed the operation on a 3D printed model of the patient's vasculature. Using this model, Dr. Pereira developed a plan to apply the robotic device that allowed the operation to be performed easily and quickly.

Successful robotic brain surgery bodes well for the transformation of the approach to treating aneurysms and strokes. This transformation will be especially relevant with the arrival of 5G networks, which will open up the ability to control robotic surgeons remotely. Such remote technologies are capable of providing unprecedented access to highly specialized medical care around the world. Corindus has already performed a number of remote heart surgeries and published the results of clinical studies.^[6]

Remote heart surgery

In early September 2019, it became known that a surgeon from India performed five percutaneous coronary intervention (PCI) operations on patients who were 30 km from him. These first remote heart operations in the world were performed using a robot developed by Corindus Vascular Robotics. The results of successful surgeries were published in EClinicalMedicine, an addendum to the medical journal The Lancet.

Dr. Tejas Patel, chief interventional cardiologist at the Heart Institute in Ahmedabad, India, used the Corindus CorPus GRX robot and wired internet connection, manipulating the robot with a set of joysticks and a video monitor. Although Corindus has conducted several remote tests in the United States, a series of operations carried out by Dr. Patel was an important milestone in medicine.

Tejas Patel demonstrates the possibility of remote operation

This is a prime example of the use of telemedicine, which could decentralize health care through the virtual distribution of doctors on the ground, offset the shortage of nurses and doctors, and potentially reduce health care costs. In France , people are already visiting Telehealth cabins for quick and convenient medical care. During the recent Ebola crisis, the University of Virginia provided care in parts of Africa with telemedicine technology.

The use of telerobotics for remote treatment can save many lives, says Dr. Patel. Telemedicine and robotics allow patients to receive specialized care that would otherwise not be possible. The success of this study paves the way for the deployment of large-scale remote telerobotic platforms around the world. Although remote robotic procedures are still in the early stages of development, it is already clear that they are the future.^[7]

2017: Sales outside the United States

In December 2017, the Indian Heart Institute installed the CorPath GRX System for percutaneous coronary intervention robotic care for training cardiologists. This robot was first installed outside the United States.

We are pleased that the global medical robotics market is growing, "says Mark Toland, President and CEO of Corindus Vascular Robotics. - We ourselves show interest in the world market and are now establishing relations with India, Japan, China and some European countries.

The first complete robotic surgery at the Indian Heart Institute Hospital was performed via left dorsal transradial access. Studies have shown that this type of surgery reduces the incidence of serious bleeding and vascular complications.

CorPath GRX System Robot

Dr. Tejas Patel, Chairman and Chief Interventional Cardiologist of the Institute, was one of the first to apply the transradial access technique and trained more than 5,000 doctors. He was "very impressed" by the capabilities of CorPath GRX in complex operations and the level of accuracy achieved. In the first three days of working with the robotic system, Patel and his team successfully completed 11 operations. Other physicians noted an intuitive control console and guiding catheter that facilitates surgery.

CorPath GRX, registered by the Food and Drug Administration (FDA) in October 2016, is a second-generation robotic system whose new capabilities, according to the creators, have improved its accuracy and enabled the system to be used for a wider range of surgical interventions.

Robotic intervention allows more precise positioning of the stent, reduces radiation exposure to both physicians and patients, and new generations of the technology may be used remotely, Toland said.

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