Remote proctoring in complex percutaneous coronary intervention aided by mixed reality technology

Area of Science:

• Interventional Cardiology
• Medical Technology
• Surgical Innovation

Background:

• Percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) presents challenges, including lower success rates and higher complication risks.
• Experienced operator supervision (proctoring) is known to improve CTO procedure success rates.
• Traditional proctoring requires in-person presence, limiting accessibility and increasing costs.

Purpose of the Study:

• To evaluate the feasibility of implementing remote proctoring for CTO procedures.
• To assess the utility of web-based communication and mixed reality (MR) technology in facilitating remote guidance during CTO interventions.

Main Methods:

• A single PCI operator utilized a Microsoft HoloLens 2 head-mounted display for real-time visual and verbal interaction with a remote proctor.
• Holographic annotations were employed for enhanced communication during the procedures.
• Ten CTO procedures were conducted with remote proctoring assistance.

Main Results:

• Successful audio and video communication was established in all ten procedures.
• The Microsoft HoloLens 2 enabled the completion of all CTO procedures.
• The PCI operator reported the remote proctoring experience as beneficial.

Conclusions:

• Remote proctoring of CTO procedures using mixed reality technology is a feasible approach.
• The effectiveness of this remote proctoring method on procedural and patient outcomes requires further investigation in future studies.