Interhospital teleproctoring of endovascular intracranial aneurysm treatment using a dedicated live-streaming technology: first experiences during the COVID-19 pandemic

BMJ Case Rep. 2020 Oct 4;13(10):e016722. doi: 10.1136/bcr-2020-016722.

Abstract

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.

Keywords: aneurysm; angiography; intervention; subarachnoid.

Publication types

  • Case Reports

MeSH terms

  • Angiography, Digital Subtraction / methods
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / prevention & control*
  • Endovascular Procedures / methods*
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / therapy*
  • Pandemics / prevention & control*
  • Pneumonia, Viral / prevention & control*
  • SARS-CoV-2
  • Telemedicine / methods*