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

2020 ◽  
Vol 13 (10) ◽  
pp. e016722
Author(s):  
Matthias Bechstein ◽  
Samer Elsheikh ◽  
Fritz Wodarg ◽  
Christian A Taschner ◽  
Uta Hanning ◽  
...  
Keyword(s):  
High Resolution ◽  
Image Transmission ◽  
Live Streaming ◽  
Short Term ◽  
Clinical Complications ◽  
Aneurysm Treatment ◽  
Travel Restrictions ◽  
Streaming Technology ◽  
Woven Endobridge

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.

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

2020 ◽  
pp. neurintsurg-2020-016722.rep
Author(s):  
Matthias Bechstein ◽  
Samer Elsheikh ◽  
Fritz Wodarg ◽  
Christian A Taschner ◽  
Uta Hanning ◽  
...  
Keyword(s):  
High Resolution ◽  
Image Transmission ◽  
Live Streaming ◽  
Short Term ◽  
Clinical Complications ◽  
Aneurysm Treatment ◽  
Travel Restrictions ◽  
Streaming Technology ◽  
Woven Endobridge

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.

scholarly journals Aneurysm Treatment With Woven EndoBridge in the Cumulative Population of 3 Prospective, Multicenter Series: 2-Year Follow-Up

Neurosurgery ◽  
2021 ◽  
Vol 89 (Supplement_2) ◽  
pp. S3-S3
Author(s):  
Laurent Pierot ◽  
Jacques Moret ◽  
Xavier Barreau ◽  
Istvan Szikora ◽  
Denis Herbreteau ◽  
...  
Keyword(s):  
Aneurysm Treatment ◽  
Woven Endobridge

scholarly journals Safety and efficacy of aneurysm treatment with WEB: results of the WEBCAST study

2016 ◽  
Vol 124 (5) ◽  
pp. 1250-1256 ◽  
Author(s):  
Laurent Pierot ◽  
Vincent Costalat ◽  
Jacques Moret ◽  
Istvan Szikora ◽  
Joachim Klisch ◽  
...  
Keyword(s):  
Clinical Status ◽  
Clinical Practices ◽  
Short Term ◽  
Safety And Efficacy ◽  
Complete Occlusion ◽  
Aneurysm Treatment ◽  
Intraoperative Rupture ◽  
Wide Neck ◽  
European Trial

OBJECT WEB is an innovative intrasaccular treatment for intracranial aneurysms. Preliminary series have shown good safety and efficacy. The WEB Clinical Assessment of Intrasaccular Aneurysm Therapy (WEBCAST) trial is a prospective European trial evaluating the safety and efficacy of WEB in wide-neck bifurcation aneurysms. METHODS Patients with wide-neck bifurcation aneurysms for which WEB treatment was indicated were included in this multicentergood clinical practices study. Clinical data including adverse events and clinical status at 1 and 6 months were collected and independently analyzed by a medical monitor. Six-month follow-up digital subtraction angiography was also performed and independently analyzed by a core laboratory. Success was defined at 6 months as complete occlusion or stable neck remnant, no worsening in angiographic appearance from postprocedure, and no retreatment performed or planned. RESULTS Ten European neurointerventional centers enrolled 51 patients with 51 aneurysms. Treatment with WEB was achieved in 48 of 51 aneurysms (94.1%). Adjunctive implants (coils/stents) were used in 4 of 48 aneurysms (8.3%). Thromboembolic events were observed in 9 of 51 patients (17.6%), resulting in a permanent deficit (modified Rankin Scale [mRS] Score 1) in 1 patient (2.0%). Intraoperative rupture was not observed. Morbidity (mRS score > 2) and mortality were 2.0% (1 of 51 patients, related to rupture status on entry to study) and 0.0% at 1 month, respectively. Success was achieved at 6 months in 85.4% of patients treated with WEB: 23 of 41 patients (56.1%) had complete occlusion, 12 of 41 (29.3%) had a neck remnant, and 6 of 41 (14.6%) had an aneurysm remnant. CONCLUSIONS The WEBCAST study showed good procedural and short-term safety of aneurysm treatment with WEB and good 6-month anatomical results.

Safety, efficacy, and short-term follow-up of the use of Pipeline™ Embolization Device in small (<2.5mm) cerebral vessels for aneurysm treatment: single institution experience

2015 ◽  
Vol 58 (3) ◽  
pp. 267-275 ◽  
Author(s):  
Ajit S. Puri ◽  
Francesco Massari ◽  
Takumi Asai ◽  
Miklos Marosfoi ◽  
Peter Kan ◽  
...  
Keyword(s):  
Cerebral Vessels ◽  
Single Institution ◽  
Short Term ◽  
Aneurysm Treatment

scholarly journals Mid-term 3T MRA follow-up of intracranial aneurysms treated with the Woven EndoBridge

2018 ◽  
Vol 24 (6) ◽  
pp. 601-607 ◽  
Author(s):  
SBT van Rooij ◽  
JP Peluso ◽  
M Sluzewski ◽  
HG Kortman ◽  
I Boukrab ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Intracranial Aneurysms ◽  
Posterior Cerebral Artery ◽  
Signal Loss ◽  
Short Term ◽  
Complete Occlusion ◽  
Woven Endobridge ◽  
The Web

Introduction Angiography is the standard follow-up modality for treated aneurysms with the Woven EndoBridge (WEB), and magnetic resonance angiography (MRA) is useful for extended follow-up. We present the results of WEB-treated aneurysms with angiographic follow-up at three months and at least 18 months’ 3T MRA follow-up. Materials and methods Included were 52 patients with 53 aneurysms treated with the WEB between February 2015 and July 2016. There were 29 women and 23 men with a mean age of 60 years (median 62, range 23–76). Mean aneurysm size was 6.2 mm (median 6, range 3–16 mm). Results 3T MRA follow-up was mean 19.6 months (median 18, range 18–36 months). One patient had an aneurysm remnant at three-month angiography that was additionally coiled and with stable complete occlusion at 18 months’ 3T MRA follow-up. At three-month follow-up angiography, 44 aneurysms were completely occluded and eight had a neck remnant. At latest 3T MRA, stable complete occlusion was present in 43 aneurysms and stable neck remnant in eight. One posterior cerebral artery (PCA) dissection aneurysm was stable at three and six months but was enlarged and reopened at 18 months, confirmed with angiography. Focal signal loss by the proximal marker of the WEB was apparent in four patients without compromising diagnostic evaluation. Conclusion WEB-treated aneurysms with adequate occlusion at three-month angiography remained stable during serial 3T MRA follow-up of 18–36 months. One PCA aneurysm reopened during the 6- to 18-month interval. Once the WEB-treated aneurysm is adequately occluded in the short term, later reopening is uncommon.

Detailed short-term follow-up high-resolution CT series of differentiation syndrome

2022 ◽  
Vol 15 (1) ◽  
pp. e242840
Author(s):  
Tatsuya Oki ◽  
Yukihiro Nagatani ◽  
Wataru Saika ◽  
Yoshiyuki Watanabe
Keyword(s):  
Retinoic Acid ◽  
High Resolution ◽  
Acute Promyelocytic Leukaemia ◽  
Ground Glass Opacity ◽  
Short Term ◽  
High Resolution Ct ◽  
Trans Retinoic Acid ◽  
All Trans Retinoic Acid ◽  
Thorax Ct

A 57-year-old man with acute promyelocytic leukaemia (APML) received induction therapy including all-trans-retinoic acid (ATRA). At day 15, he developed dyspnoea, haemoptysis and hypoxia. Thorax CT demonstrated diffuse ground-glass opacity and consolidation predominantly in dorsal regions, which may reflect increased vascular permeability. He was diagnosed with differentiation syndrome. After dexamethasone was administered and chemotherapy suspended, his symptoms improved and abnormal lesions mostly disappeared on follow-up CT examinations. We report a short-term high-resolution CT series of differentiation syndrome.

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