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The Impact of the COVID-19 Pandemic on a Dedicated Vascular Emergency Clinic

Sarah Jane Messeder1, Imelda Black2, Andrew T O Nickinson3

  • 1Department of Cardiovascular Sciences, University of Leicester, Leicester, UK; Leicester Vascular Institute, University Hospitals of Leicester NHS Trust, Leicester, UK.

Annals of Vascular Surgery
|April 6, 2023
PubMed

Insights

Vascular Emergency Clinics (VEC) maintained rapid treatment timelines for chronic limb-threatening ischemia (CLTI) patients during the COVID-19 pandemic. This study shows the VEC model

Area of Science:

  • Vascular Surgery
  • Public Health
  • Epidemiology

Background:

  • Vascular Emergency Clinics (VEC) offer a streamlined approach to managing chronic limb-threatening ischemia (CLTI).
  • The COVID-19 pandemic presented unprecedented challenges to healthcare systems globally.
  • Assessing the operational resilience of specialized clinics like VECs is crucial for maintaining patient care during public health crises.

Purpose of the Study:

  • To evaluate the resilience and effectiveness of the outpatient Vascular Emergency Clinic (VEC) model during the initial year of the COVID-19 pandemic.
  • To determine if rapid treatment timelines for patients with chronic limb-threatening ischemia (CLTI) were maintained despite pandemic-related disruptions.
  • To analyze patient outcomes and treatment strategies within the VEC framework under pandemic conditions.

Main Methods:

  • A retrospective analysis of a prospectively maintained database of patients assessed in a VEC from March 2020 to April 2021.
  • Cross-referencing VEC data with national and regional COVID-19 data to contextualize operational challenges.
  • Detailed analysis of patients diagnosed with CLTI, including assessment of Peripheral Arterial Disease-Quality Improvement Framework compliance and treatment pathways.

Main Results:

  • The VEC model demonstrated resilience, with a median referral to assessment time of 3 days for CLTI patients.
  • For non-admitted CLTI patients, median assessment to intervention was 8 days, and referral to intervention was 11 days.
  • Outcomes included a 10.9% major lower limb amputation rate and a 25.8% mortality rate at 12 months, with 58.6% undergoing a first revascularization strategy.

Conclusions:

  • The Vascular Emergency Clinic (VEC) model proved highly resilient to the challenges posed by the COVID-19 pandemic.
  • Rapid treatment timelines essential for managing chronic limb-threatening ischemia (CLTI) were successfully maintained.
  • The VEC's open-access, single-point-of-entry system facilitated continued effective patient care during the public health crisis.
Abstract

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