Changes in Neuroendovascular Procedural Volume During the COVID-19 Pandemic: An International Multicenter Study

J Neuroimaging. 2021 Jan;31(1):171-179. doi: 10.1111/jon.12803. Epub 2020 Nov 23.

Abstract

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.

Keywords: COVID-19; carotid stent; corona virus; mechanical thrombectomy; neuroendovascular procedures.

MeSH terms

  • Angioplasty / statistics & numerical data*
  • COVID-19*
  • Cerebral Angiography / statistics & numerical data*
  • Endovascular Procedures / methods
  • Endovascular Procedures / statistics & numerical data*
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / surgery
  • Intracranial Arteriovenous Malformations / diagnostic imaging
  • Intracranial Arteriovenous Malformations / surgery
  • Ischemic Stroke / diagnostic imaging
  • Ischemic Stroke / surgery
  • Pandemics
  • Stents*
  • Thrombectomy / statistics & numerical data*
  • Treatment Outcome