Thrombectomy for Treatment of Acute Stroke in the COVID-19 Pandemic

Area of Science:

• Neurology
• Infectious Diseases
• Interventional Radiology

Background:

• The 2019 novel coronavirus disease (COVID-19) pandemic has impacted various medical fields, including stroke care.
• Emerging evidence suggests a potential link between COVID-19 and cerebrovascular events, such as ischemic stroke.

Purpose of the Study:

• To review current guidelines for mechanical thrombectomy in patients with COVID-19 associated large-vessel occlusion (LVO) stroke.
• To survey the reported clinical experience of performing thrombectomy in COVID-19 patients with acute LVO stroke.
• To discuss the unique challenges encountered by neuro-interventionalists during these procedures.

Main Methods:

• Review of recently published guidelines and recommendations.
• Survey of reported case series and observational studies on thrombectomy for LVO stroke in COVID-19 patients.
• Discussion of practical considerations and challenges based on clinical experience.

Main Results:

• Guidelines for thrombectomy in COVID-19 stroke patients have been promulgated, adapting existing protocols.
• Initial experiences suggest thrombectomy can be safely performed in selected COVID-19 patients with LVO stroke.
• Specific challenges include patient isolation, personal protective equipment (PPE) use, and potential for increased bleeding risk.

Conclusions:

• Mechanical thrombectomy remains a critical treatment for acute LVO stroke, even in the context of COVID-19.
• Adherence to modified protocols and careful patient selection are essential for successful outcomes.
• Neuro-interventionalists must be prepared to manage the unique logistical and clinical challenges posed by performing thrombectomy in COVID-19 patients.