1. Neuroendovascular Treatment of Acute Stroke during Covid-19: A Guide from the Frontlines
- Author
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Randi Collinson, Melissa McCabe, Ike Thacker, Bryan Pukenas, Colin Hoey, Mougnyan Cox, Robert W. Hurst, Kennith F. Layton, Jessica Lehmann, Preethi Ramchand, David Kung, and Neda I. Sedora-Roman
- Subjects
medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,acute stroke ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,coronavirus ,030204 cardiovascular system & hematology ,medicine.disease_cause ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,mechanical thrombectomy ,0302 clinical medicine ,PPE, Personal Protective Equipment ,ACT, Activated Clotting Time ,ICU, Intensive Care Unit ,medicine ,Advanced and Specialised Nursing ,Myocardial infarction ,Acute stroke ,Coronavirus ,Advanced and Specialized Nursing ,CTA, Computed Tomography Angiography ,Radiological and Ultrasound Technology ,business.industry ,EMS, Emergency Medical Services ,IV, Intravenous Catheter ,COVID-19 ,CT, Computed Tomography ,medicine.disease ,radiology nurses ,NIHSS, National Institutes of Health Stroke Severity Scale ,Mechanical thrombectomy ,Increased risk ,Emergency medicine ,tPA, Tissue Plasminogen Activator ,business ,Loss of life - Abstract
Since the initial reports surfaced of a novel Coronavirus causing illness and loss of life in Wuhan, China, COVID-19 has rapidly spread across the globe infecting millions and leaving hundreds of thousands dead. As hospitals cope with the influx of COVID-19 patients, new challenges have arisen as healthcare systems care for COVID-19 patients while still providing essential emergency care for patients with acute strokes and acute myocardial infarction. Adding to this complex scenario are new reports that COVID-19 patients are at increased risk of thromboembolic complications including strokes. In this paper, we detail our experience caring for acute stroke patients, and provide some insight into neurointerventional workflow modifications that have helped us adapt to the COVID-19 era., Highlights: • COVID-19 continues its relentless march through the United States and the globe, presenting unique challenges for healthcare providers as they treat other emergent conditions while minimizing the risk of COVID-19 exposure and infection. • Acute stroke is especially challenging during the COVID-19 due to time constraints required for effective mechanical thrombectomy to improve neurologic outcomes and survival in patients whose COVID infection status is unknown. • The institutional protocol for mechanical thrombectomy described in this article may help inform models at other centers as they prepare for their respective COVID peaks
- Published
- 2020