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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Published on: January 18, 2018

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Results of an International Questionnaire Investigating Changes in Acute Stroke Management between Before and During

Kyohei Fujita1, Shoko Fujii1, Hiroto Yamaoka1

  • 1Department of Endovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan.

Journal of Neuroendovascular Therapy
|July 28, 2023
PubMed

Insights

Stroke management largely unchanged during COVID-19, but infection rates and patient mortality increased. This study examined changes in acute stroke care during the pandemic.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • The coronavirus disease 2019 (COVID-19) pandemic significantly impacted healthcare systems globally.
  • Acute stroke management requires timely and specialized interventions, potentially complicated by infectious disease outbreaks.

Purpose of the Study:

  • To investigate changes in acute stroke patient management before and during the COVID-19 pandemic.
  • To assess the impact of the pandemic on stroke care protocols and outcomes across different countries.

Main Methods:

  • A questionnaire survey was distributed to 23 stroke centers in 20 countries.
  • Data collected compared stroke management practices in 2019 (pre-pandemic) versus 2020 (during the pandemic).
  • Responses were analyzed from 14 stroke centers in 14 countries.

Main Results:

  • Most stroke centers (85%) maintained unchanged imaging and endovascular thrombectomy (ET) indications post-COVID-19 precautions.
  • However, 50% of centers reported a 10-70% decrease in ET procedures.
  • Confirmed COVID-19 transmission occurred in 29% of centers, with 25% experiencing hospital-acquired infections; 50% of ET patients died, often from COVID-19 complications.

Conclusions:

  • Stroke management strategies remained largely consistent, with adaptations focused on COVID-19 precautions.
  • Significant increases in hospital-acquired infections and patient morbidity/mortality were observed, linked to COVID-19 systemic complications.
  • The pandemic posed challenges to stroke care, affecting treatment volume and patient outcomes despite successful interventions.
Abstract

Keywords:
coronavirus disease 2019strokethrombectomy

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