Telemedicine in vascular surgery: clinical experience in a single centre

Over a three-year period we performed 630 carotid endarterectomy procedures in 588 patients. From these we selected 90 patients (group A) who fulfilled the criteria for discharge one day after surgery. These patients were given an electronic blood pressure meter, a videophone for use at home and an...

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Bibliographic Details
Published in:Journal of telemedicine and telecare 2010-10, Vol.16 (7), p.374-377
Main Authors: Robaldo, Alessandro, Rousas, Nikolaos, Pane, Bianca, Spinella, Giovanni, Palombo, Domenico
Format: Article
Language:English
Subjects:
Amlodipine - therapeutic use
Antihypertensive Agents - therapeutic use
Blood Pressure Monitoring, Ambulatory - methods
Carotid Stenosis - surgery
Endarterectomy, Carotid
Female
Humans
Male
Neck
Patient Satisfaction
Postoperative Care - methods
Postoperative Care - standards
Remote Consultation - methods
Self Care - methods
Self Care - psychology
Telemedicine
Telemetry - instrumentation
Telephone
Vascular surgery
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Summary:Over a three-year period we performed 630 carotid endarterectomy procedures in 588 patients. From these we selected 90 patients (group A) who fulfilled the criteria for discharge one day after surgery. These patients were given an electronic blood pressure meter, a videophone for use at home and an antihypertensive drug (amlodipine). Using web-based videoconferencing, we monitored the patients every 4 hours for the first two days. The other 498 patients (group B) were discharged on the second postoperative day. There were no significant differences between the groups in demographic characteristics, risk factors, carotid lesions, operative time, postoperative complications or blood loss. No cervical hematomas developed in group A. No patients needed to be readmitted because of major complications relating to the carotid endarterectomy. During the video-communication, 28 patients (31%) with a hypertensive crisis were treated by administration of amlodipine. At discharge, a questionnaire showed that there was a feeling of insecurity in both groups: 87% in group A vs. 79% in group B (P > 0.05). In group A, insecurity decreased after the first video connection and disappeared after the 8th day postoperatively. Telemedicine appears feasible and useful in carotid endarterectomy and may have other applications in vascular surgery care.
ISSN:1357-633X
1758-1109
DOI:10.1258/jtt.2010.091011