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4. Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Author

Ruffino, M. A., Chan, S., Coughlin, P., Awopetu, A., Stather, P., Lane, T., Theodosiou, D., Ahmed, M. A., Vasudevan, T., Ibrahim, M., Al Maadany, F., Eljareh, M., Alkhafeefi, F. S., Coscas, R., Unal, E. U., Pulli, R., Zaca, S., Angiletta, D., Kotsis, T., Moawad, M., Tozzi, M., Patelis, N., Lazaris, A. M., Chuen, J., Croo, A., Tsolaki, E., Zenunaj, G., Kamal, D., Tolba, M. M., Maresch, M., Khetarpaul, V., Mills, J., Gangwani, G., Elahwal, M., Khalil, R., Azab, M. A., Mahomed, A., Whiston, R., Contractor, U., Esposito, D., Pratesi, C., Giacomelli, E., Troncoso, M. V., Elkouri, S., Johansson, F. G., Dodos, I., Benezit, M., Vidoedo, J., Rocha-Neves, J., Pereira-Neves, A. H., Dias-Neto, M. F., Campos Jacome, A. F., Loureiro, L., Silva, I., Garza-Herrera, R., Canata, V., Bezard, C., Bowser, K., Tobar, J. F., Vera, C. G., Parra, C. S., Lopez, E., Serra, Y. G., Varela, J., Rubio, V., Victoria, G., Johnson, A., O'Banion, L. A., Makar, R., Tantawy, T. G., Storck, M., Jongkind, V., Falah, O., Mcbride, O., Isik, A., Papaioannou, A., Ocke Reis, P. E., Bracale, U. M., Atkins, E., Tinelli, Giovanni, Scott, E., Wales, L., Sivaharan, A., Priona, G., Nesbitt, C., Grainger, T., Shelmerdine, L., Chong, P., Bajwa, A., Arwynck, L., Hadjievangelou, N., Elbasty, A., Rubio, O., Ricardo, M., Ulloa, J. H., Tarazona, M., Pabon, M., Pitoulias, G., Corless, K., Ioannidis, O., Friedrich, O., Van Herzeele, I., Vijaynagar, B., Cohnert, T., Bell, R., Moore, H., Saha, P., Gifford, E., Laine, M., Barkat, A., Karkos, C., Binti Safri, L. S., Buitron, G., Del Castillo, J., Carrera, P., Salinas, N., Biagioni, R. B., Benites, S., Mafla, C. A., Pian, P. M., Albino, P., Serrano, E., Marin, A., Gonzalez, M., Foreroga, M., Russo, A., Reyes, A., Guglielmone, D., Grillo, L., Flumignan, R., Palones, F. G., Silveira, P. G., Ramely, R. B., Edeiken, S., Chetter, I., Green, L., Sudarsanam, A., Lyons, O., Lemmon, G., Neville, R., Castelli, M., Hinojosa, C. A., Carvajal, R. R., Rivera, A., Wong, P., Drudi, L., Perkins, J., Sieunarine, K., Attia, D., Atef, M., Eftychios, L., Weaver, F., Ren, L. C., Alomari, M., Jamjoom, R., Aljarrah, Q., Abbas, A., Alomran, F., Kumar, A., Altoijri, A., Elsanhoury, K. T., Alhumaid, A., Fekry, T., Sekhar, R., Theodoridis, P., Panagiotis, T., Roditis, K., Tsiantoula, P., Antoniou, A., Soler, R., Hasemaki, N., Baili, E., Mpaili, E., Huasen, B., Wallace, T., Duncan, A., Metcalfe, M., Mannoia, K., Bechara, C. F., Tsilimparis, N., Aranson, N., Riding, D., Palena, M., Mcdonnell, C., Mouawad, N. J., Banegas, S., Rossi, P., Oshodi, T., Diaz, R., Afifi, R., Dindyal, S., Thapar, A., Kordzadeh, A., Pullas, G., Lin, S., Davies, C., Darvall, K., Kodama, A., Gooneratne, T., Gunawansa, N., Munoz, A., Jie, N. J., Bradley, N., Al-Jundi, W., Meyer, F., Lee, C., Malina, M., Renton, S., Lui, D., Batchelder, A., Oszkinis, G., Freyrie, A., Giordano, J., Saratzis, N., Tigkiropoulos, K., Kyriakos, S., Popov, G., Cheema, M. U., Lapolla, P., Ling Patricia, Y. C., Ennab, R., Ullery, B. W., Pasenidou, K., Tam, J., Sidel, G., Jayaprakash, V. V., Bennett, L., Hardy, S., Davies, E., Baker, S., Wijesinghe, L., Tam, A., Mccune, K., Chana, M., Lowe, C., Goh, A., Powezka, K., Kyrou, I., Altaf, N., Harkin, D., Travers, H., Cragg, J., Sharif, A., Akhtar, T., Chavez, J. A., Ordonez, C., Mazzurco, M., Choke, E., Asghar, I., Summerour, V., Dunlop, P., Morley, R., Hardy, T., Bevis, P., Cuff, R., Stavroulakis, K., Beropoulis, E., Argyriou, A., Loftus, I., Azhar, B., Sheth, S., Usai, M. V., Choudhry, A., Nicole, K., Boyle, E., Joyce, D., Abdelaty Hassan, M. H., Saltiel, A., Frahm-Jensen, G., Antoniou, G., Elhadi, M., Kimyaghalam, A., Malgor, R., Telve, D., Isaak, A., Schmidli, J., Mckevitt, K., Siddiqui, T., Asciutto, G., Floros, N., Papadopoulos, G., Kafetzakis, A., Koutsias, S. G., Nana, P., Giannoukas, A., Kakkos, S., Moulakakis, K. G., Shafique, N., Jawien, A., Popplewell, M., Imray, C., Abayasekara, K., Rowlands, T., Kuhan, G., Rajagopalan, S., Jaipersad, A., Sadia, U., Kobe, I., Mittapalli, D., Enemosah, I., Behrendt, C. -A., Beck, A., Almudhafer, M., Ancetti, S., Jacobs, D., Jayakumar, P., Malekpour, F., Shalhub, S., Keldiyorov, B., Simon, M., Khashram, M., Rich, N., Shepherd, A., Meecham, L., Doherty, D., Benson, R. A., Tinelli G. (ORCID:0000-0002-2212-3226), Ruffino, M. A., Chan, S., Coughlin, P., Awopetu, A., Stather, P., Lane, T., Theodosiou, D., Ahmed, M. A., Vasudevan, T., Ibrahim, M., Al Maadany, F., Eljareh, M., Alkhafeefi, F. S., Coscas, R., Unal, E. U., Pulli, R., Zaca, S., Angiletta, D., Kotsis, T., Moawad, M., Tozzi, M., Patelis, N., Lazaris, A. M., Chuen, J., Croo, A., Tsolaki, E., Zenunaj, G., Kamal, D., Tolba, M. M., Maresch, M., Khetarpaul, V., Mills, J., Gangwani, G., Elahwal, M., Khalil, R., Azab, M. A., Mahomed, A., Whiston, R., Contractor, U., Esposito, D., Pratesi, C., Giacomelli, E., Troncoso, M. V., Elkouri, S., Johansson, F. G., Dodos, I., Benezit, M., Vidoedo, J., Rocha-Neves, J., Pereira-Neves, A. H., Dias-Neto, M. F., Campos Jacome, A. F., Loureiro, L., Silva, I., Garza-Herrera, R., Canata, V., Bezard, C., Bowser, K., Tobar, J. F., Vera, C. G., Parra, C. S., Lopez, E., Serra, Y. G., Varela, J., Rubio, V., Victoria, G., Johnson, A., O'Banion, L. A., Makar, R., Tantawy, T. G., Storck, M., Jongkind, V., Falah, O., Mcbride, O., Isik, A., Papaioannou, A., Ocke Reis, P. E., Bracale, U. M., Atkins, E., Tinelli, Giovanni, Scott, E., Wales, L., Sivaharan, A., Priona, G., Nesbitt, C., Grainger, T., Shelmerdine, L., Chong, P., Bajwa, A., Arwynck, L., Hadjievangelou, N., Elbasty, A., Rubio, O., Ricardo, M., Ulloa, J. H., Tarazona, M., Pabon, M., Pitoulias, G., Corless, K., Ioannidis, O., Friedrich, O., Van Herzeele, I., Vijaynagar, B., Cohnert, T., Bell, R., Moore, H., Saha, P., Gifford, E., Laine, M., Barkat, A., Karkos, C., Binti Safri, L. S., Buitron, G., Del Castillo, J., Carrera, P., Salinas, N., Biagioni, R. B., Benites, S., Mafla, C. A., Pian, P. M., Albino, P., Serrano, E., Marin, A., Gonzalez, M., Foreroga, M., Russo, A., Reyes, A., Guglielmone, D., Grillo, L., Flumignan, R., Palones, F. G., Silveira, P. G., Ramely, R. B., Edeiken, S., Chetter, I., Green, L., Sudarsanam, A., Lyons, O., Lemmon, G., Neville, R., Castelli, M., Hinojosa, C. A., Carvajal, R. R., Rivera, A., Wong, P., Drudi, L., Perkins, J., Sieunarine, K., Attia, D., Atef, M., Eftychios, L., Weaver, F., Ren, L. C., Alomari, M., Jamjoom, R., Aljarrah, Q., Abbas, A., Alomran, F., Kumar, A., Altoijri, A., Elsanhoury, K. T., Alhumaid, A., Fekry, T., Sekhar, R., Theodoridis, P., Panagiotis, T., Roditis, K., Tsiantoula, P., Antoniou, A., Soler, R., Hasemaki, N., Baili, E., Mpaili, E., Huasen, B., Wallace, T., Duncan, A., Metcalfe, M., Mannoia, K., Bechara, C. F., Tsilimparis, N., Aranson, N., Riding, D., Palena, M., Mcdonnell, C., Mouawad, N. J., Banegas, S., Rossi, P., Oshodi, T., Diaz, R., Afifi, R., Dindyal, S., Thapar, A., Kordzadeh, A., Pullas, G., Lin, S., Davies, C., Darvall, K., Kodama, A., Gooneratne, T., Gunawansa, N., Munoz, A., Jie, N. J., Bradley, N., Al-Jundi, W., Meyer, F., Lee, C., Malina, M., Renton, S., Lui, D., Batchelder, A., Oszkinis, G., Freyrie, A., Giordano, J., Saratzis, N., Tigkiropoulos, K., Kyriakos, S., Popov, G., Cheema, M. U., Lapolla, P., Ling Patricia, Y. C., Ennab, R., Ullery, B. W., Pasenidou, K., Tam, J., Sidel, G., Jayaprakash, V. V., Bennett, L., Hardy, S., Davies, E., Baker, S., Wijesinghe, L., Tam, A., Mccune, K., Chana, M., Lowe, C., Goh, A., Powezka, K., Kyrou, I., Altaf, N., Harkin, D., Travers, H., Cragg, J., Sharif, A., Akhtar, T., Chavez, J. A., Ordonez, C., Mazzurco, M., Choke, E., Asghar, I., Summerour, V., Dunlop, P., Morley, R., Hardy, T., Bevis, P., Cuff, R., Stavroulakis, K., Beropoulis, E., Argyriou, A., Loftus, I., Azhar, B., Sheth, S., Usai, M. V., Choudhry, A., Nicole, K., Boyle, E., Joyce, D., Abdelaty Hassan, M. H., Saltiel, A., Frahm-Jensen, G., Antoniou, G., Elhadi, M., Kimyaghalam, A., Malgor, R., Telve, D., Isaak, A., Schmidli, J., Mckevitt, K., Siddiqui, T., Asciutto, G., Floros, N., Papadopoulos, G., Kafetzakis, A., Koutsias, S. G., Nana, P., Giannoukas, A., Kakkos, S., Moulakakis, K. G., Shafique, N., Jawien, A., Popplewell, M., Imray, C., Abayasekara, K., Rowlands, T., Kuhan, G., Rajagopalan, S., Jaipersad, A., Sadia, U., Kobe, I., Mittapalli, D., Enemosah, I., Behrendt, C. -A., Beck, A., Almudhafer, M., Ancetti, S., Jacobs, D., Jayakumar, P., Malekpour, F., Shalhub, S., Keldiyorov, B., Simon, M., Khashram, M., Rich, N., Shepherd, A., Meecham, L., Doherty, D., Benson, R. A., and Tinelli G. (ORCID:0000-0002-2212-3226)

Abstract

Objective: To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. Methods: An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March – May 2020, “period 1”), and then again between May and June (“period 2”) and June and July 2020 (“period 3”). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume. Results: The impact of the pandemic continued to be felt well after countries’ first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence. Conclusion: Centres reported a broad return of services approaching pre-pandemic “normal” by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries.

Published
2022

15. Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Author

Ruth A. Benson, Maria Antonella Ruffino, Sharon Chan, Patrick Coughlin, Ayoola Awopetu, Philip Stather, Tristan Lane, Dimitrios Theodosiou, Mohamed Abozeid Ahmed, Thodur Vasudevan, Mohammed Ibrahim, Faraj Al Maadany, Mohamed Eljareh, Fatimah Saad Alkhafeefi, Raphael Coscas, Ertekin Utku Ünal, Raffaele Pulli, Sergio Zacà, Domenico Angiletta, Thomas Kotsis, Magdy Moawad, Matteo Tozzi, Nikolaos Patelis, Andreas M. Lazaris, Jason Chuen, Alexander Croo, Elpiniki Tsolaki, Gladiol Zenunaj, Dhafer Kamal, Mahmoud MH. Tolba, Martin Maresch, Vipul Khetarpaul, Joseph Mills, Gaurav Gangwani, Mohamed Elahwal, Rana Khalil, Mohammed A. Azab, Anver Mahomed, Richard Whiston, Ummul Contractor, Davide Esposito, Carlo Pratesi, Elena Giacomelli, Martín Veras Troncoso, Stephane Elkouri, Flavia Gentile Johansson, Ilias Dodos, Marie Benezit, José Vidoedo, João Rocha-Neves, António Henrique Pereira-Neves, Marina Felicidade Dias-Neto, Ana Filipa Campos Jácome, Luis Loureiro, Ivone Silva, Rodrigo Garza-Herrera, Victor Canata, Charlotte Bezard, Kathryn Bowser, Jorge Felipe Tobar, Carlos Gomez Vera, Carolina Salinas Parra, Eugenia Lopez, Yvis Gadelha Serra, Juan Varela, Vanessa Rubio, Gerardo Victoria, Adam Johnson, Leigh Ann O’Banion, Ragai Makar, Tamer Ghatwary Tantawy, Martin Storck, Vincent Jongkind, Orwa falah, Olivia McBride, Arda Isik, Athanasios Papaioannou, Paulo Eduardo Ocke Reis, Umberto Marcello Bracale, Ellie Atkins, Giovanni Tinelli, Emma Scott, Lucy Wales, Ashwin Sivaharan, Georgia Priona, Craig Nesbitt, Tabitha Grainger, Lauren Shelmerdine, Patrick Chong, Adnan Bajwa, Luke Arwynck, Nancy Hadjievangelou, Ahmed Elbasty, Oscar Rubio, Michael Ricardo, Jorge H. Ulloa, Marcos Tarazona, Manuel Pabon, Georgios Pitoulias, Kevin Corless, Orestis Ioannidis, Oliver Friedrich, Isabelle Van Herzeele, Badri Vijaynagar, Tina Cohnert, Rachel Bell, Hayley Moore, Prakash Saha, Edward Gifford, Matti Laine, Adel Barkat, Christos Karkos, Lenny Suryani Binti Safri, Gabriel Buitron, Javier Del Castillo, Paul Carrera, Nilson Salinas, Rodrigo Bruno Biagioni, Sergio Benites, César Andrés Mafla, Putera Mas Pian, Pereira Albino, Ernesto Serrano, Andres Marin, Marco González, Marsha Foreroga, Alejandro Russo, Andrés Reyes, Daniel Guglielmone, Lorena Grillo, Ronald Flumignan, Francisco Gomez Palones, Pierre Galvagni Silveira, Rosnelifaizur Bin Ramely, Sara Edeiken, Ian Chetter, Lucy Green, Abhilash Sudarsanam, Oliver Lyons, Gary Lemmon, Richard Neville, Mariano Castelli, Carlos A. Hinojosa, Rubén Rodríguez Carvajal, Aksim Rivera, Peng Wong, Laura Drudi, Jeremy Perkins, Kishore Sieunarine, Doaa Attia, Mahmoud Atef, Lostoridis Eftychios, Fred Weaver, Leong Chuo Ren, Mohannad Alomari, Reda Jamjoom, Qusai Aljarrah, Ayman Abbas, Faris Alomran, Ambrish Kumar, Abdulmajeed Altoijri, Kareem T. ElSanhoury, Ahmed Alhumaid, Tamer Fekry, Raghuram Sekhar, Panagiotis Theodoridis, Theodoridis Panagiotis, Konstantinos Roditis, Paraskevi Tsiantoula, Afroditi Antoniou, Raphael Soler, Natasha Hasemaki, Efstratia Baili, Eustratia Mpaili, Bella Huasen, Tom Wallace, Andrew Duncan, Matthew Metcalfe, Kristyn Mannoia, Carlos F. Bechara, Nikolaos Tsilimparis, Nathan Aranson, David Riding, Mariano Palena, Ciarán McDonnell, Nicolas J. Mouawad, Shonda Banegas, Peter Rossi, Taohid Oshodi, Rodney Diaz, Rana Afifi, Shiva Dindyal, Ankur Thapar, Ali Kordzadeh, Gonzalo Pullas, Stephanie Lin, Chris Davies, Katy Darvall, Akio Kodama, Thushan Gooneratne, Nalaka Gunawansa, Alberto Munoz, Ng Jun Jie, Nicholas Bradley, Wissam Al-Jundi, Felicity Meyer, Cheong Lee, Martin Malina, Sophie Renton, Dennis Lui, Andrew Batchelder, Grzegorz Oszkinis, Antonio Freyrie, Jacopo Giordano, Nikolaos Saratzis, Konstantinos Tigkiropoulos, Stavridis Kyriakos, Guriy Popov, Muhammad Usman Cheema, Pierfrancesco Lapolla, Yih Chun Ling Patricia, Raed Ennab, Brant W. Ullery, Ketino Pasenidou, Jacky Tam, Gabriel Sidel, Vivek Vardhan Jayaprakash, Lisa Bennett, Simon Hardy, Emma Davies, Sara Baker, Lasantha Wijesinghe, Adam Tam, Ken McCune, Manik Chana, Chris Lowe, Aaron Goh, Katarzyna Powezka, Ioanna Kyrou, Nishath Altaf, Denis Harkin, Hannah Travers, James Cragg, Atif sharif, Tasleem Akhtar, José Antonio Chávez, Claudia Ordonez, Martin Mazzurco, Edward Choke, Imran Asghar, Virginia Summerour, Paul Dunlop, Rachel Morley, Thomas Hardy, Paul Bevis, Robert Cuff, Konstantinos Stavroulakis, Efthymios Beropoulis, Angeliki Argyriou, Ian Loftus, Bilal Azhar, Sharvil Sheth, Marco Virgilio Usai, Asad Choudhry, Kira Nicole, Emily Boyle, Doireann Joyce, Mohammed Hassan Abdelaty Hassan, Alberto Saltiel, Gert Frahm-Jensen, George Antoniou, Muhammed Elhadi, Ali Kimyaghalam, Rafael Malgor, Leigh Ann O'Banion, Diego Telve, Andrej Isaak, Jürg Schmidli, Kevin McKevitt, Tam Siddiqui, Giuseppe Asciutto, Nikolaos Floros, George Papadopoulos, Alexandros Kafetzakis, Stylianos G. Koutsias, Petroula Nana, Athanasios Giannoukas, Stavros Kakkos, Konstantinos G. Moulakakis, Natasha Shafique, Arkadiusz Jawien, Matthew Popplewell, Chris Imray, Kumar Abayasekara, Timothy Rowlands, Ganesh Kuhan, Sriram Rajagopalan, Anthony Jaipersad, Uzma Sadia, Isaac Kobe, Devender Mittapalli, Ibrahim Enemosah, Christian-Alexander Behrendt, Adam Beck, Muayyad Almudhafer, Stefano Ancetti, Donald Jacobs, Priya Jayakumar, Fatemeh Malekpour, Sherene Shalhub, Boboyor Keldiyorov, Meryl Simon, Manar Khashram, Nicole Rich, Amanda Shepherd, Lewis Meecham, Daniel Doherty, Surgery, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, Benson, Ruth A, Bracale, Umberto Marcello, Ruffino M.A., Chan S., Coughlin P., Awopetu A., Stather P., Lane T., Theodosiou D., Ahmed M.A., Vasudevan T., Ibrahim M., Al Maadany F., Eljareh M., Alkhafeefi F.S., Coscas R., Unal E.U., Pulli R., Zaca S., Angiletta D., Kotsis T., Moawad M., Tozzi M., Patelis N., Lazaris A.M., Chuen J., Croo A., Tsolaki E., Zenunaj G., Kamal D., Tolba M.M., Maresch M., Khetarpaul V., Mills J., Gangwani G., Elahwal M., Khalil R., Azab M.A., Mahomed A., Whiston R., Contractor U., Esposito D., Pratesi C., Giacomelli E., Troncoso M.V., Elkouri S., Johansson F.G., Dodos I., Benezit M., Vidoedo J., Rocha-Neves J., Pereira-Neves A.H., Dias-Neto M.F., Campos Jacome A.F., Loureiro L., Silva I., Garza-Herrera R., Canata V., Bezard C., Bowser K., Tobar J.F., Vera C.G., Parra C.S., Lopez E., Serra Y.G., Varela J., Rubio V., Victoria G., Johnson A., O'Banion L.A., Makar R., Tantawy T.G., Storck M., Jongkind V., falah O., McBride O., Isik A., Papaioannou A., Ocke Reis P.E., Bracale U.M., Atkins E., Tinelli G., Scott E., Wales L., Sivaharan A., Priona G., Nesbitt C., Grainger T., Shelmerdine L., Chong P., Bajwa A., Arwynck L., Hadjievangelou N., Elbasty A., Rubio O., Ricardo M., Ulloa J.H., Tarazona M., Pabon M., Pitoulias G., Corless K., Ioannidis O., Friedrich O., Van Herzeele I., Vijaynagar B., Cohnert T., Bell R., Moore H., Saha P., Gifford E., Laine M., Barkat A., Karkos C., Binti Safri L.S., Buitron G., Del Castillo J., Carrera P., Salinas N., Biagioni R.B., Benites S., Mafla C.A., Pian P.M., Albino P., Serrano E., Marin A., Gonzalez M., Foreroga M., Russo A., Reyes A., Guglielmone D., Grillo L., Flumignan R., Palones F.G., Silveira P.G., Ramely R.B., Edeiken S., Chetter I., Green L., Sudarsanam A., Lyons O., Lemmon G., Neville R., Castelli M., Hinojosa C.A., Carvajal R.R., Rivera A., Wong P., Drudi L., Perkins J., Sieunarine K., Attia D., Atef M., Eftychios L., Weaver F., Ren L.C., Alomari M., Jamjoom R., Aljarrah Q., Abbas A., Alomran F., Kumar A., Altoijri A., ElSanhoury K.T., Alhumaid A., Fekry T., Sekhar R., Theodoridis P., Panagiotis T., Roditis K., Tsiantoula P., Antoniou A., Soler R., Hasemaki N., Baili E., Mpaili E., Huasen B., Wallace T., Duncan A., Metcalfe M., Mannoia K., Bechara C.F., Tsilimparis N., Aranson N., Riding D., Palena M., McDonnell C., Mouawad N.J., Banegas S., Rossi P., Oshodi T., Diaz R., Afifi R., Dindyal S., Thapar A., Kordzadeh A., Pullas G., Lin S., Davies C., Darvall K., Kodama A., Gooneratne T., Gunawansa N., Munoz A., Jie N.J., Bradley N., Al-Jundi W., Meyer F., Lee C., Malina M., Renton S., Lui D., Batchelder A., Oszkinis G., Freyrie A., Giordano J., Saratzis N., Tigkiropoulos K., Kyriakos S., Popov G., Cheema M.U., Lapolla P., Ling Patricia Y.C., Ennab R., Ullery B.W., Pasenidou K., Tam J., Sidel G., Jayaprakash V.V., Bennett L., Hardy S., Davies E., Baker S., Wijesinghe L., Tam A., McCune K., Chana M., Lowe C., Goh A., Powezka K., Kyrou I., Altaf N., Harkin D., Travers H., Cragg J., sharif A., Akhtar T., Chavez J.A., Ordonez C., Mazzurco M., Choke E., Asghar I., Summerour V., Dunlop P., Morley R., Hardy T., Bevis P., Cuff R., Stavroulakis K., Beropoulis E., Argyriou A., Loftus I., Azhar B., Sheth S., Usai M.V., Choudhry A., Nicole K., Boyle E., Joyce D., Abdelaty Hassan M.H., Saltiel A., Frahm-Jensen G., Antoniou G., Elhadi M., Kimyaghalam A., Malgor R., Telve D., Isaak A., Schmidli J., McKevitt K., Siddiqui T., Asciutto G., Floros N., Papadopoulos G., Kafetzakis A., Koutsias S.G., Nana P., Giannoukas A., Kakkos S., Moulakakis K.G., Shafique N., Jawien A., Popplewell M., Imray C., Abayasekara K., Rowlands T., Kuhan G., Rajagopalan S., Jaipersad A., Sadia U., Kobe I., Mittapalli D., Enemosah I., Behrendt C.-A., Beck A., Almudhafer M., Ancetti S., Jacobs D., Jayakumar P., Malekpour F., Shalhub S., Keldiyorov B., Simon M., Khashram M., Rich N., Shepherd A., Meecham L., Doherty D., and Benson R.A.

Subjects
Vascular surgery, Peripheral artery disease, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Abdominal aortic aneurysm, COVID-19, 610 Medicine & health, Surgery, AAA, Cardiology and Cardiovascular Medicine, Survey, Settore MED/22 - CHIRURGIA VASCOLARE, PAD
Abstract

OBJECTIVE To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. METHODS An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March - May 2020, "period 1"), and then again between May and June ("period 2") and June and July 2020 ("period 3"). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume. RESULTS The impact of the pandemic continued to be felt well after countries' first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence. CONCLUSION Centres reported a broad return of services approaching pre-pandemic "normal" by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries.

Published
2022
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16. Surgical OFF-LOADING of the diabetic foot.

Author

Dalla Paola L, Carone A, Valente M, Palena M, and Scavone G

Abstract

Diabetic foot ulcer treatment is a challenge for the healthcare world. Widespread infection and the presence of critical ischemia (especially with end-stage renal disease) can lead to major amputation rather than amenable to conservative treatment. Surgical strategies of the diabetic foot have been changing over the past 10 years and are now focused on reconstructive treatment and limb salvage. These goals were achieved, thanks to an evolution of distal revascularization techniques and a distinct approach, which integrates various methods focused on limb salvage. Podoplastic techniques of the diabetic foot are focused on infection clearance, the surgical treatment of corrective deformities, soft tissue coverage and limb ischemia correction along with the management of diabetes and the comorbidities that compromise tissue repair processes. The reconstructive techniques used in diabetic foot treatment owe their effectiveness in part to the results of technological improvements such as the circular external fixator as a tool for stabilization and surgical site protection. In the last decade, many studies have shown that circular external fixation should be considered as the most useful method to protect the reconstructive surgical site in limb salvage of the diabetic foot. The objective of this review is to highlight the role of surgical offloading using circular external fixation as an adjunct to the podoplastic diabetic foot reconstruction procedures., (© 2021 Delhi Orthopedic Association. All rights reserved.)

Published
2021
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17. Prolonged high-pressure balloon angioplasty of femoropopliteal lesions: Impact on stent implantation rate and mid-term outcome.

Author

Rigatelli G, Palena M, Cardaioli P, dell'Avvocata F, Giordan M, Vassilev D, and Manzi M

Abstract

Objectives: To assess the impact on stent implantation rate and mid-term outcomes of prolonged high pressure angioplasty of femoropopliteal lesions., Methods: We retrospectively enrolled 620 consecutive patients from January 2011 to December 2011 (75.6 ± 12.3 years, 355 males, 76.5% in Rutherford class 5-6), referred for critical limb ischemia and submitted to prolonged high-pressure angioplasty of femoropopliteal lesions. The definition of prolonged high-pressure angioplasty includes dilation to at least 18 atm for at least 120 s. Procedural data, and clinical and instrumental follow-up were analyzed to assess stent implantation rate and mid-term outcomes., Results: The preferred approach was ipsilateral femoral antegrade in 433/620 patients (69.7%) and contralateral cross-over in 164/620 (26.4%) and popliteal retrograde + femoral antegrade in 23/620 (3.7%). Techniques included subintimal angioplasty in 427/620 patients (68.8%) and endoluminal angioplasty in 193/620 patients (31.2%). The prolonged high pressure balloon angioplasty procedure was successful in 86.2% (minor intra-procedural complications rate 15.7 %), stent implantation was performed in 74 patients (11.9%), with a significant improvement of ankle-brachial index (0.29 ± 0.6 vs. 0.88 ± 0.3, P < 00.1) and Rutherford class (5.3 ± 0.8 vs. 0.7 ± 1.9, P < 0.01), a primary patency rate of 86.7%, restenosis of 18.6 % on Doppler ultrasound and a target lesion revascularization of 14.8% at a mean follow-up of 18.1 ± 6.4 months (range 1-24 months). Secondary patency rate was 87.7%., Conclusions: Prolonged high pressure angioplasty of femoropopliteal lesions appears to be safe and effective allowing for an acceptable patency and restenosis rates on mid-term.

Published
2014
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