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International Experience of Mechanical Thrombectomy During the COVID-19 Pandemic: Insights from STAR and ENRG

Authors :
Clemens M. Schirmer
Sharon Webb
Shakeel Chowdry
Albert J Yoo
Andrew F. Ducruet
Ansaar T Rai
Andrew W. Grande
Stacey Q Wolfe
Min S. Park
Nitin Goyal
Richard Williamson
Jonathan A Grossberg
Peter Kan
Santiago Gomez-Paz
R. Webster Crowley
Ahmad Sweid
Ilko Maier
Waldo R. Guerrero
Christopher S. Ogilvy
Abhi Pandhi
Muhammad Ubaid Hafeez
Marios Psychogios
Kyle M Fargen
Alejandro M Spiotta
Stavropoula Tjoumakaris
Michael R. Levitt
William J. Ares
Justin R Mascitelli
Ali Alawieh
Robert M. Starke
Charles C. Matouk
Brian M. Howard
Pascal Jabbour
Krishna C Joshi
Sami Al Kasab
Roberto Crosa
Andrew J. Ringer
Maxim Mokin
Vasu Saini
Isabel Fragata
Eyad Almallouhi
Adam S Arthur
Christine A Holmstedt
Source :
Journal of Neurointerventional Surgery
Publication Year :
2020
Publisher :
BMJ, 2020.

Abstract

BackgroundIn response to the COVID-19 pandemic, many centers altered stroke triage protocols for the protection of their providers. However, the effect of workflow changes on stroke patients receiving mechanical thrombectomy (MT) has not been systematically studied.MethodsA prospective international study was launched at the initiation of the COVID-19 pandemic. All included centers participated in the Stroke Thrombectomy and Aneurysm Registry (STAR) and Endovascular Neurosurgery Research Group (ENRG). Data was collected during the peak months of the COVID-19 surge at each site. Collected data included patient and disease characteristics. A generalized linear model with logit link function was used to estimate the effect of general anesthesia (GA) on in-hospital mortality and discharge outcome controlling for confounders.Results458 patients and 28 centers were included from North America, South America, and Europe. Five centers were in high-COVID burden counties (HCC) in which 9/104 (8.7%) of patients were positive for COVID-19 compared with 4/354 (1.1%) in low-COVID burden counties (LCC) (PConclusionWe observed a low rate of COVID-19 infection among stroke patients undergoing MT in LCC. Overall, more than half of the patients underwent intubation prior to MT, leading to prolonged door to reperfusion time, higher in-hospital mortality, and lower likelihood of functional independence at discharge.

Details

Language :
English
Database :
OpenAIRE
Journal :
Journal of Neurointerventional Surgery
Accession number :
edsair.doi.dedup.....7e7e254db703e2acdee7f217feb6a039