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European Society of Minimally Invasive Neurological Therapy (ESMINT) recommendations for optimal interventional neurovascular management in the COVID-19 era
  1. Mohamed Aggour1,
  2. Phil White2,3,
  3. Zsolt Kulcsar4,
  4. Jens Fiehler5,
  5. Patrick Brouwer6,7
  1. 1 Saint Etienne, Rhone-Alpes, France
  2. 2 Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK
  3. 3 Neuroradiology, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
  4. 4 Neuroradiology, Zurich University Hospital, Zurich, Switzerland
  5. 5 Department of Neuroradiology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
  6. 6 Neuroradiology, Karolinska Universitetssjukhuset, Stockholm, Sweden
  7. 7 University NeuroVascular Center - UNVC, LUMC Leiden / HMC The Hague, Netherlands
  1. Correspondence to Dr Mohamed Aggour, Saint Etienne, Rhone-Alpes, France; aggour.mohamed{at}

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The Coronavirus Disease 2019 (COVID-19) pandemic began in December 2019 in Wuhan, China. The outbreak is due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Healthcare contamination and infection rates are thought to be very high (up to 29% in a recent Chinese publication1).

These recommendations are not intended to overrule local official safety measures and guidelines but rather to give other insights and perspectives while facing this exceptional situation in the safest way possible for your patient, team, family and yourself.


  • Early detection and limiting exposure of healthcare workers (HCWs), employees and patients.

  • Maintenance of urgent interventional neuroradiology (INR) procedures with adequate staff, materials and precautions.

  • Provide infection control tutorials led by hospital infection control experts, as well ensure the availability of personal protective equipment (PPE) and education for HCWs.

  • Ensure all department employees are aware of, and are performing, recommended infection control protocols.

  • Review and practice protocols for decontaminating imaging rooms after caring for a COVID-19 patient.

  • Implementation of ‘social distancing’ strategies for staff, trainees and faculty.

  • Staff protection and their families.

  • Adequate mental health and managing stress overload for HCWs.

General considerations about patients and protocols

  • It is advised to limit neurointerventional activity only for acute and relative INR emergencies that cannot be reasonably postponed.

  • Limit interventions to those that will actively affect the outcome of your patient with no borderline/extended indications where patients may not benefit from intervention.

  • Before accepting a patient in transfer that may need an intensive care unit (ICU) bed later or a long continuous monitoring post-intervention it is important to verify the capacity and availability of such management internally. It might be beneficial to consider re-dispatching patients after intervention to their primary care hospital of origin if possible. It is important to have daily feedback about available ICU beds, as well as anesthesia and staff …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement There are no data in this work