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Initial Stroke Thrombectomy Experience in New York City during the COVID-19 Pandemic
K A Yaeger1, J T Fifi2, J Lara-Reyna2
1From the Department of Neurosurgery, Mount Sinai Health System, New York, New York. Kurt.yaeger@mountsinai.org.
Insights
During the COVID-19 pandemic, mechanical thrombectomy remained a safe and effective treatment for emergent large-vessel occlusion stroke patients. Early COVID-19 positive patients undergoing thrombectomy did not experience critical respiratory illness.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- New York City became the epicenter of the COVID-19 pandemic, straining healthcare resources.
- Cerebrovascular diseases remained a significant health burden despite resource diversion.
- Policy changes impacted healthcare delivery during the pandemic.
Purpose of the Study:
- To review thrombectomy outcomes in emergent large-vessel occlusion (ELVO) patients during the COVID-19 pandemic.
- To assess the safety and efficacy of thrombectomy amidst resource reallocation.
- To determine the incidence of COVID-19 positivity in ELVO patients and its impact.
Main Methods:
- Retrospective review of 10 ELVO patients undergoing thrombectomy.
- Data collection on patient demographics, COVID-19 status, and procedural outcomes.
- Analysis of reperfusion rates, procedural times, and neurological improvement (NIHSS scores).
Main Results:
- 9 out of 10 patients achieved successful reperfusion.
- Median time from vascular access to reperfusion was 37 minutes.
- Average improvement in NIHSS score was 7.7 points post-procedure.
- Five patients tested positive for COVID-19; none developed critical respiratory illness.
Conclusions:
- Mechanical thrombectomy is an effective treatment for ELVO even during the COVID-19 pandemic.
- Thrombectomy procedures were safely performed for patients, including those who tested positive for COVID-19.
- The study demonstrates the continued viability of thrombectomy services during a public health crisis.
Abstract:
New York City has become the global epicenter of the coronavirus 2019 (COVID-19) pandemic. Despite a massive shift in health care resources, cerebrovascular disease continues to be a substantial burden. We review the first 10 patients undergoing thrombectomy following a series of governmental and institutional policy changes diverting resources to the care of critically ill patients with COVID-19. Ten patients with emergent large-vessel occlusion underwent thrombectomy between March 23 and April 1, 2020. Five patients tested positive for the COVID-19 virus. Successful reperfusion was achieved in 9 of 10 patients, at a median time of 37 minutes from vascular access. The postprocedural NIHSS score improved by an average of 7.7 points. Of the 5 patients positive for COVID-19, none have experienced a critical respiratory illness. We report the early incidence of COVID-19 positivity in patients with emergent large-vessel occlusion and demonstrate that thrombectomy continues to be an efficacious option, as well as safe for health care providers.
