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Changes in Neuroendovascular Procedural Volume During the COVID-19 Pandemic: An International Multicenter Study
Adnan I Qureshi1, Samiat Agunbiade1,2, Wei Huang1
1Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO.
Insights
The COVID-19 pandemic significantly reduced neuroendovascular procedures like cerebral angiograms and thrombectomies. However, treatment for ruptured intracranial aneurysms increased, showing shifts in neuroendovascular care during the pandemic.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Public Health
Background:
- The impact of the coronavirus disease 2019 (COVID-19) pandemic on neuroendovascular procedures remains unquantified.
- Understanding these changes is crucial for assessing healthcare provision and identifying vulnerable procedures.
Purpose of the Study:
- To audit and quantify the effect of the COVID-19 pandemic on the performance of neuroendovascular procedures.
- To identify specific neuroendovascular procedures most affected by the pandemic.
Main Methods:
- An international multicenter audit of neuroendovascular procedures was conducted across 18 institutions in seven countries.
- Data from January-April 2019 and 2020 were compared, analyzing procedural volumes and categorizing institutions by COVID-19 prevalence.
Main Results:
- Significant reductions were observed in cerebral angiograms, mechanical thrombectomies, carotid artery stenting, intracranial angioplasty/stenting, and treatment of unruptured aneurysms and brain arteriovenous malformations.
- An increase was noted in the treatment of ruptured intracranial aneurysms and other neuroendovascular procedures.
- Procedural volume changes did not correlate with COVID-19 prevalence in different regions, with most reductions occurring in March-April 2020.
Conclusions:
- The study provides an international perspective on how the COVID-19 pandemic altered neuroendovascular practices.
- It highlights specific procedures susceptible to changes in care delivery during public health crises.
Background And Purpose:
The effect of coronavirus disease 2019 (COVID-19) pandemic on performance of neuroendovascular procedures has not been quantified.
Methods:
We performed an audit of performance of neuroendovascular procedures at 18 institutions (seven countries) for two periods; January-April 2019 and 2020, to identify changes in various core procedures. We divided the region where the hospital was located based on the median value of total number of COVID-19 cases per 100,00 population-into high and low prevalent regions.
Results:
Between 2019 and 2020, there was a reduction in number of cerebral angiograms (30.9% reduction), mechanical thrombectomy (8% reduction), carotid artery stent placement for symptomatic (22.7% reduction) and asymptomatic (43.4% reduction) stenoses, intracranial angioplasty and/or stent placement (45% reduction), and endovascular treatment of unruptured intracranial aneurysms (44.6% reduction) and ruptured (22.9% reduction) and unruptured brain arteriovenous malformations (66.4% reduction). There was an increase in the treatment of ruptured intracranial aneurysms (10% increase) and other neuroendovascular procedures (34.9% increase). There was no relationship between procedural volume change and intuitional location in high or low COVID-19 prevalent regions. The procedural volume reduction was mainly observed in March-April 2020.
Conclusions:
We provided an international multicenter view of changes in neuroendovascular practices to better understand the gaps in provision of care and identify individual procedures, which are susceptible to change.
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