Training and Supervision of Thrombectomy by Remote Live Streaming Support (RESS)
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Training and Supervision of Thrombectomy by Remote Live Streaming Support (RESS) : Randomized Comparison Using Simulated Stroke Interventions. / Bechstein, Matthias; Buhk, Jan-Hendrik; Frölich, Andreas Maximilian; Broocks, Gabriel; Hanning, Uta; Erler, Martin; Anđelković, Milan; Debeljak, Dragan; Fiehler, Jens; Goebell, Einar.
in: CLIN NEURORADIOL, Jahrgang 31, Nr. 1, 03.2021, S. 181-187.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Training and Supervision of Thrombectomy by Remote Live Streaming Support (RESS)
T2 - Randomized Comparison Using Simulated Stroke Interventions
AU - Bechstein, Matthias
AU - Buhk, Jan-Hendrik
AU - Frölich, Andreas Maximilian
AU - Broocks, Gabriel
AU - Hanning, Uta
AU - Erler, Martin
AU - Anđelković, Milan
AU - Debeljak, Dragan
AU - Fiehler, Jens
AU - Goebell, Einar
PY - 2021/3
Y1 - 2021/3
N2 - PURPOSE: Stroke patients are excluded from expeditious thrombectomy in regions lacking neurointerventional specialists. An audiovisual online streaming system was tested, allowing a neurointerventional specialist located at a neurovascular center to supervise and instruct a thrombectomy performed at a distant hospital without being physically present (remote streaming support [RESS]).METHODS: In total, 36 thrombectomy procedures were performed on a Mentice endovascular simulator by six radiologists not specialized in neurointerventions. Each radiologist was challenged with six different endovascular simulation scenarios under alternating conventional local support (specialist inside the room [LOS]) and RESS, which was performed using an advanced live streaming platform.RESULTS: Both support modes led to a median of 2 attempts (interquartile range [IQR] 2.0-2.0 each) until successful recanalization. There was no statistically significant difference in time from first catheter insertion to recanalization between LOS (median 24.9 min, IQR 21.0-31.5 min) and RESS (23.9 min, IQR 21.7-28.7 min, p = 0.89). The percentage of thrombi covered by the stent-retriever and average speed when retrieving the stent-retriever (3.7 mm/s, IQR 3.25-5.35 mm/s vs. 3.6 mm/sec, IQR 2.5-4.7) were similar in both groups. Fluoroscopy time did not differ (19.0 min, IQR 16.9-23.5 min vs. 19.9 min, IQR 15.9-23.5 min) with a trend towards increased median amounts of contrast medium used under RESS (62.9 ml vs. 43.1 ml; p = 0.055).CONCLUSION: This study confirmed the feasibility of RESS for thrombectomy procedures in a simulated environment. This serves as basis for future studies planned to analyze the effectiveness of RESS in a real-world environment and to test if it improves the learning curve of interventionalists with limited thrombectomy experience in remote areas.
AB - PURPOSE: Stroke patients are excluded from expeditious thrombectomy in regions lacking neurointerventional specialists. An audiovisual online streaming system was tested, allowing a neurointerventional specialist located at a neurovascular center to supervise and instruct a thrombectomy performed at a distant hospital without being physically present (remote streaming support [RESS]).METHODS: In total, 36 thrombectomy procedures were performed on a Mentice endovascular simulator by six radiologists not specialized in neurointerventions. Each radiologist was challenged with six different endovascular simulation scenarios under alternating conventional local support (specialist inside the room [LOS]) and RESS, which was performed using an advanced live streaming platform.RESULTS: Both support modes led to a median of 2 attempts (interquartile range [IQR] 2.0-2.0 each) until successful recanalization. There was no statistically significant difference in time from first catheter insertion to recanalization between LOS (median 24.9 min, IQR 21.0-31.5 min) and RESS (23.9 min, IQR 21.7-28.7 min, p = 0.89). The percentage of thrombi covered by the stent-retriever and average speed when retrieving the stent-retriever (3.7 mm/s, IQR 3.25-5.35 mm/s vs. 3.6 mm/sec, IQR 2.5-4.7) were similar in both groups. Fluoroscopy time did not differ (19.0 min, IQR 16.9-23.5 min vs. 19.9 min, IQR 15.9-23.5 min) with a trend towards increased median amounts of contrast medium used under RESS (62.9 ml vs. 43.1 ml; p = 0.055).CONCLUSION: This study confirmed the feasibility of RESS for thrombectomy procedures in a simulated environment. This serves as basis for future studies planned to analyze the effectiveness of RESS in a real-world environment and to test if it improves the learning curve of interventionalists with limited thrombectomy experience in remote areas.
U2 - 10.1007/s00062-019-00870-5
DO - 10.1007/s00062-019-00870-5
M3 - SCORING: Journal article
C2 - 31863121
VL - 31
SP - 181
EP - 187
JO - CLIN NEURORADIOL
JF - CLIN NEURORADIOL
SN - 1869-1439
IS - 1
ER -