Endovascular thrombectomy time metrics in the era of COVID-19: observations from the Society of Vascular and Interventional Neurology Multicenter Collaboration

Alexandra L Czap; Alicia M Zha; Jacob Sebaugh; Ameer E Hassan; Julie G Shulman; Mohamad Abdalkader; Thanh N Nguyen; Italo Linfante; Amy Kathryn Starosciak; Santiago Ortega-Gutierrez; Mudassir Farooqui; Darko Quispe-Orozco; Nirav A Vora; Vivek Rai; Raul G Nogueira; Diogo C Haussen; Dinesh V Jillella; Ameena Rana; Siyuan Yu; Jesse M Thon; Osama O Zaidat; Priyank Khandelwal; Ivo Bach; Sunil A Sheth; Ashutosh P Jadhav; Shashvat M Desai; Tudor G Jovin; David S Liebeskind; James E Siegler

doi:10.1136/neurintsurg-2020-017205

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Endovascular thrombectomy time metrics in the era of COVID-19: observations from the Society of Vascular and Interventional Neurology Multicenter Collaboration

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Endovascular thrombectomy time metrics in the era of COVID-19: observations from the Society of Vascular and Interventional Neurology Multicenter Collaboration

Alexandra L Czap, Alicia M Zha, Jacob Sebaugh, Ameer E Hassan, Julie G Shulman, Mohamad Abdalkader, Thanh N Nguyen, Italo Linfante, Amy Kathryn Starosciak, Santiago Ortega-Gutierrez, …

Journal of neurointerventional surgery, Vol.14(1), p.27

02/08/2021

DOI: 10.1136/neurintsurg-2020-017205

PMID: 33558439

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Abstract

BackgroundUnprecedented workflow shifts during the coronavirus disease 2019 (COVID-19) pandemic have contributed to delays in acute care delivery, but whether it adversely affected endovascular thrombectomy metrics in acute large vessel occlusion (LVO) is unknown.MethodsWe performed a retrospective review of observational data from 14 comprehensive stroke centers in nine US states with acute LVO. EVT metrics were compared between March to July 2019 against March to July 2020 (primary analysis), and between state-specific pre-peak and peak COVID-19 months (secondary analysis), with multivariable adjustment.ResultsOf the 1364 patients included in the primary analysis (51% female, median NIHSS 14 [IQR 7–21], and 74% of whom underwent EVT), there was no difference in the primary outcome of door-to-puncture (DTP) time between the 2019 control period and the COVID-19 period (median 71 vs 67 min, P=0.10). After adjustment for variables associated with faster DTP, and clustering by site, there remained a trend toward shorter DTP during the pandemic (βadj=-73.2, 95% CI −153.8–7.4, Pp=0.07). There was no difference in DTP times according to local COVID-19 peaks vs pre-peak months in unadjusted or adjusted multivariable regression (βadj=-3.85, 95% CI −36.9–29.2, P=0.80). In this final multivariable model (secondary analysis), faster DTP times were significantly associated with transfer from an outside institution (βadj=-46.44, 95% CI −62.8 to – -30.0, P<0.01) and higher NIHSS (βadj=-2.15, 95% CI −4.2to – -0.1, P=0.05).ConclusionsIn this multi-center study, there was no delay in EVT among patients treated for intracranial occlusion during the COVID-19 era compared with the pre-COVID era.

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Title: Subtitle: Endovascular thrombectomy time metrics in the era of COVID-19: observations from the Society of Vascular and Interventional Neurology Multicenter Collaboration
Creators: Alexandra L Czap - The University of Texas Health Science Center
Alicia M Zha - The University of Texas Health Science Center
Jacob Sebaugh - The University of Texas Health Science Center
Ameer E Hassan - The University of Texas Rio Grande Valley
Julie G Shulman - Boston Medical Center
Mohamad Abdalkader - Boston Medical Center
Thanh N Nguyen - Boston Medical Center
Italo Linfante - Department of Interventional Neuroradiology and Endovascular Neurosurgery, Baptist Health South Florida, Coral Gables, Florida, USA.
Amy Kathryn Starosciak - Baptist Hospital of Miami
Santiago Ortega-Gutierrez - University of Iowa
Mudassir Farooqui - University of Iowa
Darko Quispe-Orozco - University of Iowa
Nirav A Vora - Riverside Methodist Hospital
Vivek Rai - Riverside Methodist Hospital
Raul G Nogueira - Grady Memorial Hospital
Diogo C Haussen - Grady Memorial Hospital
Dinesh V Jillella - Emory University
Ameena Rana - Cooper Medical School of Rowan University
Siyuan Yu - Cooper Medical School of Rowan University
Jesse M Thon - Cooper University Health Care
Osama O Zaidat - Bon Secours Mercy Health
Priyank Khandelwal - Rutgers, The State University of New Jersey
Ivo Bach - Rutgers, The State University of New Jersey
Sunil A Sheth - The University of Texas Health Science Center
Ashutosh P Jadhav - University of Pittsburgh Medical Center
Shashvat M Desai - University of Pittsburgh Medical Center
Tudor G Jovin - Cooper University Health Care
David S Liebeskind - Ronald Reagan UCLA Medical Center
James E Siegler - Cooper University Hospital
Resource Type: Journal article
Publication Details: Journal of neurointerventional surgery, Vol.14(1), p.27
DOI: 10.1136/neurintsurg-2020-017205
PMID: 33558439
NLM abbreviation: J Neurointerv Surg
ISSN: 1759-8478
eISSN: 1759-8486
Language: English
Date published: 02/08/2021
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984302207902771

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