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Updated: Dec 7, 2025

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
MENA-SINO Consensus Statement on Implementing Care Pathways for Acute Neurovascular Emergencies During the COVID-19
Hosam Al-Jehani1,2, Seby John3, Syed Irteza Hussain3
1Department of Neurosurgery and Interventional Radiology, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Insights
The COVID-19 pandemic created challenges for neurovascular emergency care. This paper provides recommendations for managing stroke and related conditions during the pandemic.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Public Health
Background:
- The COVID-19 pandemic significantly impacted acute neurovascular care, including stroke and aneurysmal subarachnoid hemorrhage.
- Challenges include medical staff shortages, patient avoidance of care, PPE scarcity, and reduced ICU/stroke unit capacity.
Purpose of the Study:
- To develop guiding recommendations for acute care pathways for neurovascular emergencies during the COVID-19 pandemic.
- To address the challenges posed by the pandemic to endovascular therapy for stroke and other cerebrovascular conditions.
Main Methods:
- A task force comprising multidisciplinary medical staff and physicians was established by the Middle East North Africa Stroke and Interventional Neurotherapies Organization (MENA-SINO).
- A series of meetings were conducted to finalize consensus recommendations.
Main Results:
- The task force developed guiding recommendations for implementing acute care pathways.
- These recommendations aim to mitigate the impact of the pandemic on neurovascular emergency management.
Conclusions:
- Consensus recommendations were achieved through collaborative meetings.
- These guidelines are crucial for optimizing neurovascular emergency care during the COVID-19 pandemic.
Abstract:
In the unprecedented current era of the COVID-19 pandemic, challenges have arisen in the management and interventional care of patients with acute stroke and large vessel occlusion, aneurysmal subarachnoid hemorrhage, and ruptured vascular malformations. There are several challenges facing endovascular therapy for stroke, including shortages of medical staff who may be deployed for COVID-19 coverage or who may have contracted the infection and are thus quarantined, patients avoiding early medical care, a lack of personal protective equipment, delays in door-to-puncture time, anesthesia challenges, and a lack of high-intensity intensive care unit and stroke ward beds. As a leading regional neurovascular organization, the Middle East North Africa Stroke and Interventional Neurotherapies Organization (MENA-SINO) has established a task force composed of medical staff and physicians from different disciplines to establish guiding recommendations for the implementation of acute care pathways for various neurovascular emergencies during the current COVID-19 pandemic. This consensus recommendation was achieved through a series of meetings to finalize the recommendation.
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