Long-term Outcomes of a Telementoring Program for Distant Teaching of Endovascular Aneurysm Repair.

Détails

ID Serval
serval:BIB_E85135296673
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Long-term Outcomes of a Telementoring Program for Distant Teaching of Endovascular Aneurysm Repair.
Périodique
Journal of endovascular therapy
Auteur(s)
Porretta A.P., Alerci M., Wyttenbach R., Antonucci F., Cattaneo M., Bogen M., Toderi M., Guerra A., Sartori F., Di Valentino M., Tutta P., Limoni C., Gallino A., von Segesser L.K.
ISSN
1545-1550 (Electronic)
ISSN-L
1526-6028
Statut éditorial
Publié
Date de publication
12/2017
Peer-reviewed
Oui
Volume
24
Numéro
6
Pages
852-858
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
To prospectively evaluate the long-term outcomes after a telementoring program for distant teaching of endovascular aneurysm repair (EVAR) and the degree of EVAR procedure assimilation into routine practice.
A telementoring protocol using stepwise introduction of EVAR was implemented between a university care center and a remote vascular health care site; from March 1999 to October 2003, 49 EVAR patients (mean age 72 years; 48 men) were treated during telementoring at the remote center. After the telementoring period, 86 patients (mean age 71 years; 77 men) underwent EVAR procedures carried out at the secondary care center from November 2003 to July 2011. The long-term outcomes were compared between the EVAR procedures performed during telementoring with the procedures performed independently thereafter.
No significant difference was appreciated between telementored and not telementored procedures either in 30-day mortality (4.1% vs 2.3%, p=0.621) or in the initial technical success (93.9% vs 97.7%, p=0.353). The telementored group showed no significant difference in overall aneurysm-related mortality (6.1% vs 2.3%, p=0.353) or in the overall complication rates (p=0.985). The reintervention rate was significantly lower among the unmentored procedures (11.6% vs 32.7%, p=0.004). In particular, significantly fewer patients underwent late endovascular procedures (1.2% vs 12.2%, p=0.009) and late percutaneous interventions (7.0% vs 20.4%, p=0.027) after telementoring ceased.
The telementoring program followed here allowed excellent EVAR skill assimilation into the routine practice of a remote health care site. Telementoring is a feasible strategy to support skill introduction in remote medical facilities.
Mots-clé
Aged, Aortic Aneurysm, Abdominal/mortality, Aortic Aneurysm, Abdominal/surgery, Aortography/methods, Blood Vessel Prosthesis Implantation/adverse effects, Blood Vessel Prosthesis Implantation/education, Blood Vessel Prosthesis Implantation/mortality, Clinical Competence, Computed Tomography Angiography, Computer-Assisted Instruction/methods, Curriculum, Education, Distance/methods, Endovascular Procedures/adverse effects, Endovascular Procedures/education, Endovascular Procedures/mortality, Female, Humans, Male, Mentors, Postoperative Complications/mortality, Postoperative Complications/surgery, Program Evaluation, Prospective Studies, Reoperation, Risk Factors, Telemedicine/methods, Time Factors, Treatment Outcome, abdominal aortic aneurysm, distant teaching, endovascular aneurysm repair, remote teaching, telementoring
Pubmed
Web of science
Création de la notice
25/09/2017 15:14
Dernière modification de la notice
20/08/2019 17:11
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