Influence of coronavirus disease 2019 (COVID-19) on working flow,safety and efficacy outcome of mechanical thrombectomy for acute ischemic stroke with large vessel occlusion

Abstract

Aim

The epidemic of COVID-19 has greatly affect the world health care system, particular measures have been taken not only to provide safety for health care providers but also to maintain the treatment quality. We evaluate the effect of COVID-19 epidemic to acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) received endovascular treatment (EVT) in our institution.

Methods

AIS patients with LVO who underwent EVT in the period of January 1st to April 30th between 2015 and 2020 from our stroke center. The baseline characteristics, working flow time, safety and efficacy outcome and the hospitalization status were retrospectively reviewed, compared and analyzed.

Results

There is significant decline in the number of AIS patients with LVO treated compared with the previous year (36 Vs 72 patients) during the epidemic period. The door to puncture time was significantly prolong (225 minutes versus 115 minutes) as well as the length of hospital stay with increase of the hospitalization costs (P < 0.05 for all). There is no significant difference on the safety and efficacy outcome, such recanalization rate, incidence of intracranial hemorrhage, functional independence and mortality during the epidemic (P > 0.05 for all).

Conclusions

Prolongation of the working time flow during the COVID-19 epidemic did not influence the safety and efficacy of EVT in AIS patients with LVO. However, special policy and particular measures in this circumstances is still need to evolve to improve the treatment quality.

Keywords

COVID-19 epidemic acute ischemic stroke large vessel occlusion endovascular treatment

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References

Mahajan

Hirsch

JA.

Novel coronavirus: what neuroradiologists as citizens of the world need to know.

AJNR Am J Neuroradiol 2020; 41: 552–554.

Fraser

Arthur

Chen

, et al. Society of NeuroInterventional Surgery recommendations for the care of emergent neurointerventional patients in the setting of COVID-19. J Neurointerv Surg 2020; 12: 539–541.

Dafer

Osteraas

Biller

Acute stroke care in the coronavirus disease 2019 pandemic. J Stroke Cerebrovasc Dis 2020; 29: 104881.

Baracchini

Pieroni

Viaro

, et al. Acute stroke management pathway during coronavirus-19 pandemic. Neurol Sci 2020; 41: 1003–1005.

Zhao

Rudd

Liu

Challenges and potential solutions of stroke care during the coronavirus disease 2019 (COVID-19) outbreak.

Stroke 2020; 51: 1356–1357.

Kayan

Meyers

Prestigiacomo

, et al. Current endovascular strategies for posterior circulation large vessel occlusion stroke: report of the Society of NeuroInterventional Surgery Standards and Guidelines Committee. J Neurointerv Surg 2019; 11: 1055–1062.

Turc

Bhogal

Fischer

, et al. European Stroke Organisation (ESO)-European Society for Minimally Invasive Neurological Therapy (ESMINT) guidelines on mechanical thrombectomy in acute ischemic stroke. J Neurointerv Surg 2019; 11: 535–538.

Wang

Chen

, et al. Providing uninterrupted care during COVID-19 pandemic: experience from Beijing Tiantan Hospital. Stroke Vasc Neurol 2020; 5: 180–184.

Markus

Brainin

COVID-19 and stroke – a global World Stroke Organization perspective.

Int J Stroke 2020; 15: 361–364.

10.

July

Pranata

Impact of the coronavirus disease pandemic on the number of strokes and mechanical thrombectomies: a systematic review and meta-analysis. J Stroke Cerebrovasc Dis 2020; 29: 105185.

11.

Hong

Wang

, et al. Prevention and control of COVID-19 in neurointerventional surgery: expert consensus from the Chinese Federation of Interventional and Therapeutic Neuroradiology (CFITN) and the International Society for Neurovascular Disease (ISNVD). J Neurointerv Surg 2020; 12: 658–663

12.

Altschul

Haranhalli

Esenwa

, et al. The impact of COVID-19 on emergent large-vessel occlusion: delayed presentation confirmed by ASPECTS. AJNR Am J Neuroradiol 2020; 41: 2271–2273.