Three-Dimensional Teleradiology for Surveillance following Endovascular Aortic Aneurysm Repair: A Feasibility Study

Purpose: To study the feasibility of 3-dimensional (3D) teleradiology in surveillance of patients treated with stent-grafts for abdominal aortic aneurysm (AAA). Methods: Between April 2002 and November 2003, 8 AAA patients (7 men; median age 73 years, range 62–84) with stent-grafts had follow-up com...

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Bibliographic Details
Published in:Journal of endovascular therapy 2005-04, Vol.12 (2), p.196-199
Main Authors: Kaspersen, Jon H., Aasland, Jenny, Leira, Håkon O., Ødegård, Asbjørn, Nagelhus, Bjørn, Størset, Gunnar, Lundbom, Jan, Rosenlund, Thomas T., Tjora, Aksel, Myhre, Hans O.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Angioplasty
Aortic Aneurysm, Abdominal - diagnostic imaging
Aortic Aneurysm, Abdominal - surgery
Cost Savings
Feasibility Studies
Female
Follow-Up Studies
Humans
Imaging, Three-Dimensional - economics
Male
Middle Aged
Norway
Patient Satisfaction
Teleradiology - economics
Tomography, X-Ray Computed - economics
Tomography, X-Ray Computed - methods
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Summary:Purpose: To study the feasibility of 3-dimensional (3D) teleradiology in surveillance of patients treated with stent-grafts for abdominal aortic aneurysm (AAA). Methods: Between April 2002 and November 2003, 8 AAA patients (7 men; median age 73 years, range 62–84) with stent-grafts had follow-up computed tomograms (CT) performed at their local hospital and transmitted without loss across a broadband connection to the university hospital. On both monitors, the radiologists were presented with the complete CT axial dataset, sagittal and coronal reformatted slices, and a 3D volume-rendered reconstruction. The two radiologists were then able to simultaneously perform measurements and real-time manipulations of the axial and 3D pictures, which were discussed over the telephone or using a videoconferencing unit. Patient satisfaction, the radiologists' evaluation of the method, and the potential cost savings were explored. Results: Twelve follow-up CT scans were performed on the 8 patients. The time for transmission over the teleradiological network averaged 5 minutes, and the evaluation required 15 minutes at the university hospital. The overall technical quality of the images was rated as good by the university radiologist. In 11 studies, the stent-grafts were satisfactory, but a type III endoleak was detected in one 5.5-year-old stent-graft. Neither radiologist had a problem identifying the endoleak. Patients had confidence that the examination at the local hospital was of good quality; they all felt that they received good care and were pleased with avoiding travel to the university hospital. From the economic analysis, an annual savings of 40,000 Euros (US$52,304) was projected, mostly due to avoiding hospital stays and outpatient consultations at the university hospital. Conclusions: The experiences from this study are encouraging, but a larger series will be necessary for a thorough evaluation of 3D teleradiology as a surveillance method for aortic stent-graft patients.
ISSN:1526-6028
1545-1550
DOI:10.1583/04-1422.1