Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Feb;13(2):e1.
doi: 10.1136/neurintsurg-2020-016722.rep. Epub 2020 Oct 20.

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

Matthias Bechstein  1 , Samer Elsheikh  2 , Fritz Wodarg  3 , Christian A Taschner  2 , Uta Hanning  4 , Jan-Hendrik Buhk  5 , Rosalie McDonough  4 , Einar Goebell  4 , Jens Fiehler  4 , Maxim Bester  4
Affiliations
Case Reports

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

Matthias Bechstein et al. J Neurointerv Surg. 2021 Feb.

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.

PubMed Disclaimer

Conflict of interest statement

Competing interests: JF: research support: German Ministry of Science and Education, German Ministry of Economy and Innovation, German Research Foundation, European Union, Hamburgische Investitions- und Förderbank, Medtronic, Microvention, Route92, Stryker; consultant for Acandis, Bayer, Boehringer Ingelheim, Cerenovus, Evasc Neurovascular, MD Clinicals, Medtronic, Microvention, Penumbra, Phenox, Stryker and Transverse Medical; stock holder: Tegus Medical.

Figures

Figure 1
Figure 1
Live telestream set-up for remote proctoring. (A) Stand-alone rig with the installed high-definition web camera (red box). (B) Screenshot of the device set-up as seen by the proctor from his computer. The proctor can change the field of view, focus and zoom with dedicated buttons on the streaming platform. (C) Screenshot of the proctor’s selected field of view with visibility of the angiography monitors (sample image taken during a thrombectomy).
Figure 2
Figure 2
Digital subtraction angiography images of the treated aneurysms in each of the three patients: (A–C) before treatment and (D–F) after treatment.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Bechstein M, Buhk J-H, Frölich AM, et al. . Training and supervision of thrombectomy by Remote Live Streaming Support (RESS) : randomized comparison using simulated stroke interventions. Clin Neuroradiol 2019:00870–5. 10.1007/s00062-019-00870-5 - DOI - PubMed
    1. Hollander JE, Carr BG. Virtually perfect? Telemedicine for Covid-19. N Engl J Med 2020;382:1679–81. 10.1056/NEJMp2003539 - DOI - PubMed
    1. Fiehler J, Brouwer P, Díaz C, et al. . COVID-19 and Neurointerventional service worldwide: a survey of the European Society of Minimally Invasive Neurological Therapy (ESMINT), the Society of NeuroInterventional Surgery (SNIS), the Sociedad Iberolatinoamericana de Neuroradiologia Diagnostica Y Terapeutica (SILAN), the Society of Vascular and Interventional Neurology (SVIN), and the world Federation of Interventional and Therapeutic Neuroradiology (WFITN). J NeuroInterv Surg 2020. - PMC - PubMed
    1. Noorian AR, Bahr Hosseini M, Avila G, et al. . Use of wearable technology in remote evaluation of acute stroke patients: feasibility and reliability of a Google Glass-based device. J Stroke Cerebrovasc Dis 2019;28:104258. 10.1016/j.jstrokecerebrovasdis.2019.06.016 - DOI - PubMed
    1. Mendes Pereira V, Cancelliere NM, Nicholson P, et al. . First-In-Human, robotic-assisted neuroendovascular intervention. J Neurointerv Surg 2020;12:338–40. 10.1136/neurintsurg-2019-015671.rep - DOI - PMC - PubMed

Publication types