With the recent advances in artificial intelligence and robotics, there has been increasing attention to its integration in the field of medicine. Most recently, medical professionals in Korea have achieved the first successful robotic-assisted cardiovascular intervention on a patient with angina.

The team led by Professor Seung-Whan Lee and Professor Tae Oh Kim of the Division of Cardiology at Asan Medical Center recently announced the successful treatment of Mr. Ji (50 years old), who was suffering from angina, using a robotic-assisted percutaneous coronary intervention. Using the robot, Mr. Ji was treated more precisely and safely and was discharged in good health just a day after the intervention, without any complications.

The procedure is particularly significant as it was performed using the ‘1st Robot’ for coronary intervention, developed by professionals in Korea, in a market that has depended on foreign-made robots in the market, such as those from the United States, Germany, and France.

AVIAR, a coronary intervention assistant robot developed by a team led by Professor Jaesoon Choi of the Biomedical Engineering Research Center and Professor Young-Hak Kim of the Division of Cardiology at Asan Medical Center, was approved by the Ministry of Food and Drug Safety in February. Currently, it is being used in actual procedures for empirical clinical research at Asan Medical Center and the Catholic University of Korea Eunpyeong St. Mary's Hospital, with plans for international expansion such as in the United States and Europe.

Percutaneous coronary intervention (PCI) involves the insertion of a thin catheter through the femoral artery in the patient’s groin or blood vessels of the wrist, reaching the coronary artery. The procedure includes the inflation of a balloon to widen the narrowed coronary artery and the placement of a stent. This method is typically performed on patients with angina or myocardial infarction, where the coronary arteries are narrowed or blocked due to atherosclerosis or blood clots.

Given the delicate nature of the procedure, which involves inserting a hair-thin catheter into microvessels, and the variability and complexity of coronary artery lesions in each patient, the skill of experienced medical professionals is crucial.

Additionally, since the intervention deals with the unseen vascular structures within the body, real-time X-ray images are used to ensure the precise placement of the stent. Medical professionals performing the procedure face significant and repeated exposure to radiation during the X-ray imaging process, posing potential risks.

The cardiovascular intervention assist robot consists of a handle equivalent to a physician's hand and a computer. Using a joystick-like handle, medical professionals guide a guidewire into the patient's coronary artery, up to the target lesion, before introducing the balloon and stent for vascular expansion. The handle moves with a precise 1mm accuracy with each motion, and it is equipped with haptic feedback to allow the medical professionals to sense fine details during the procedure as if using their actual hands.

The computer component of the cardiovascular intervention assist robot displays various data required for the procedure based on artificial intelligence, assisting medical professionals in accurately assessing the surgical situation. It analyzes the curves of the patient's blood vessels during the procedure and indicates any abnormal signs.

Traditionally, procedures heavily relied on the expertise of skilled medical professionals. However, the use of the cardiovascular intervention assist robot allows for fine adjustments using the robot, enabling more precise and sophisticated surgery.

Furthermore, the use of the cardiovascular intervention assist robot allows medical professionals to perform procedures remotely, away from the X-ray machine used during the intervention. This is expected to reduce both the radiation exposure for medical professionals and patients and shorten the duration of the procedure.

Professor Seung-Whan Lee from the Division of Cardiology at Asan Medical Center stated, "By using the robot for fine adjustments, we were able to insert the stent accurately without errors, resulting in the patient being discharged without complications. The use of the cardiovascular intervention assist robot allows for more precise procedures, providing expectations for safer treatment for patients with complex or difficult-to-treat coronary artery lesions."

▲ AVIAR, Korea’s first coronary intervention assistant robot developed by the team led by Professor Jaesoon Choi of the Biomedical Engineering Research Center and Professor Young-Hak Kim of the Division of Cardiology at Asan Medical Center

Developed based on Asan Medical Center's medical robot technology and expertise, the cardiovascular intervention assist robot, named 'AVIAR,' is currently undergoing commercialization through LN Robotics.

The cardiovascular intervention assist robot successfully passed clinical trials, including exploration, with an initial prototype in October 2019. After three years of improvement and enhancement, it received approval from the Ministry of Food and Drug Safety in February. In October, it achieved its first successful patient procedure at Asan Medical Center, marking the first domestically developed robot in a market previously dominated by foreign products. The initiative signifies a move towards independence from foreign technologies and plans for international expansion to the United States and Europe.

In addition to its groundbreaking domestic presence, the Korean cardiovascular intervention assist robot sets itself apart by allowing the simultaneous use of up to four different surgical tools, compared to foreign robots that could only use one guide wire and one surgical tool at a time. This capability is expected to simplify procedures for patients with complex conditions.

Professor Jaesoon Choi of the Biomedical Engineering Research Center at Asan Medical Center expressed optimism, stating, "The use of the cardiovascular intervention assist robot opens up possibilities for remote interventions for emergency patients and non-face-to-face interventions for patients at risk of infection. Through telemedicine, we anticipate an enhancement in the medical standards of underserved regions. Our plan is to further advance the robot to apply it not only to coronary arteries but also to various cerebrovascular and peripheral vascular interventions."