The safety and feasibility of live-stream proctoring for CTO procedures

Document Type

Conference Proceeding

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Publication Title

Acta Cardiol


Background/Introduction: Compared with other percutaneous coronary interventions, chronic total occlusions carries a higher risk of complications, has lower success rates, and higher costs. Multiple types of educational programs have been offered (theoretical courses, live demonstrations) and for the moment on-site direct supervision with proctoring seems to be the most effective method to improve the outcome of CTO PCI procedures. In-person proctoring requires a considerable amount of arrangements and planning, which limits the number of proctoring sessions, prolong the training period, and makes the training process less efficient.

Purpose: To assess a new method of educational training, based on audio-video communication between a physician and all cath lab members with an expert that are in different locations.

Methods: The study group consisted of nine patients who underwent PCI CTO using the Virtual Proctoring approach. The strategy of the CTO PCI procedure and all the decisions through the intervention were taken only by the proctor.

Results: All the procedural steps were performed by the operator guided by the remote proctor. No single decision was taken by the operator alone as the proctor was able to notice perfectly all the angiographic details and all the other important parameters recorded by the AV system. No major complications occurred during the index hospitalization.

Conclusions: A new method of virtual proctoring based on live video-communication is feasible and safe even in the case of highly complex CTO PCI procedures. This modern approach is easy to organize between physicians regardless of their location. It could potentially increase global interaction between colleagues and facilitate sharing of knowledge which are both major key aspects in the development of the CTO PCI field. This trial could serve as a basis for future large studies to fully analyze the potential role and benefits of virtual proctoring for complex CTO PCI procedures.



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