title: Telemedicine in vascular surgery: clinical experience in a single centre.
abstract: 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 video phone for use at home and an antihypertensive drug (amlodipine). Using web-based video conferencing, 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.
authors.affiliation: Division of Vascular and Endovascular Surgery, San Martino University Hospital, Genoa, Italy. robaldo.alessandro@gmail.com
authors.forename: Alessandro
authors.initials: A
authors.lastname: Robaldo
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Rousas
authors.forename: Bianca
authors.initials: B
authors.lastname: Pane
authors.forename: Giovanni
authors.initials: G
authors.lastname: Spinella
authors.forename: Domenico
authors.initials: D
authors.lastname: Palombo
mesh_terms: D017311:Amlodipine / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D016893:Carotid Stenosis / Q000601:surgery*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000379:methods* / Q000592:standards; D019114:Remote Consultation / Q000379:methods*; D012648:Self Care / Q000379:methods / Q000523:psychology; D013686:Telemetry / Q000295:instrumentation; D013689:Telephone; D014741:Video Recording
chemical_list: D000959:Antihypertensive Agents; D017311:Amlodipine