Bechstein Matthias, Elsheikh Samer, Wodarg Fritz, Taschner Christian A, Hanning Uta, Buhk Jan-Hendrik, McDonough Rosalie, Goebell Einar, Fiehler Jens, Bester Maxim
Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Department of Neuroradiology, University Medical Center Freiburg, Freiburg, Germany.
BMJ Case Rep. 2020 Oct 4;13(10):e016722. doi: 10.1136/bcr-2020-016722.
This is a report of the first three cases of endovascular aneurysm treatment that were proctored by a remote interventionalist using a novel high-resolution low-latency streaming technology. The proctor was located in a neurovascular centre and supported the treating interventional teams in two distant cities (up to 800 km/500 miles apart). All aneurysms were treated using the Woven EndoBridge (WEB) embolisation system, either electively or following subarachnoid haemorrhage. On-site proctoring was not possible due to travel restrictions during the COVID-19 pandemic. WEB placement was feasible in all cases. Good rapport between proctors and treating physicians was reported, enabled by the high-resolution image transmission and uninterrupted feedback/discussion via audiostream. No clinical complications were encountered. Short-term follow-up revealed adequate occlusion of all treated aneurysms. The employed streaming technology provided effective remote proctoring during complex aneurysm cases, including the management of technical complications.
这是关于前三例血管内动脉瘤治疗的报告，这些治疗由远程介入专家通过一种新型高分辨率低延迟流技术进行指导。指导专家位于一个神经血管中心，为两个相距遥远的城市（相距达800公里/500英里）的治疗介入团队提供支持。所有动脉瘤均使用编织型血管内桥接（WEB）栓塞系统进行治疗，治疗时机为择期或在蛛网膜下腔出血后。由于2019年冠状病毒病大流行期间的旅行限制，无法进行现场指导。在所有病例中，放置WEB都是可行的。据报告，由于高分辨率图像传输以及通过音频流进行的不间断反馈/讨论，指导专家与治疗医生之间建立了良好的融洽关系。未遇到临床并发症。短期随访显示，所有治疗的动脉瘤均实现了充分闭塞。所采用的流技术在复杂动脉瘤病例的治疗过程中，包括技术并发症的处理，提供了有效的远程指导。
