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Ischemic Stroke
Original research
Impact of the COVID-19 pandemic on the process and outcome of thrombectomy for acute ischemic stroke
  1. Bin Yang1,
  2. Tao Wang1,
  3. Jian Chen1,
  4. Yanfei Chen1,
  5. Yabing Wang1,
  6. Peng Gao2,
  7. Guilin Li1,
  8. Fei Chen3,
  9. Long Li1,
  10. Zheng Wang2,
  11. Hongqi Zhang1,
  12. Haiqing Song3,
  13. Qingfeng Ma3,
  14. Liqun Jiao1,2
  1. 1 Department of Neurosurgery, Xuanwu Hospital, Beijing, China
  2. 2 Department of Interventional Neuroradiology, Xuanwu Hospital, Beijing, China
  3. 3 Department of Neurology, Xuanwu Hospital, Beijing, China
  1. Correspondence to Dr Liqun Jiao, Department of Neurosurgery, Xuanwu Hospital, Beijing 100005, China; liqunjiao{at}sina.cn

Abstract

Background The novel coronavirus disease 2019 (COVID-19) pandemic is still spreading across the world. Although the pandemic has an all-round impact on medical work, the degree of its impact on endovascular thrombectomy (EVT) for patients with acute ischemic stroke (AIS) is unclear.

Methods We continuously included AIS patients with large artery occlusion who underwent EVT in a comprehensive stroke center before and during the Wuhan shutdown. The protected code stroke (PCS) for screening and treating AIS patients was established during the pandemic. The efficacy and safety outcomes including the rate of successful reperfusion (defined as modified Thrombolysis In Cerebral Infarction (mTICI) graded 2b or 3) and time intervals for reperfusion were compared between two groups: pre-pandemic and pandemic.

Results A total of 55 AIS patients who received EVT were included. The baseline characteristics were comparable between the two groups. The time from hospital arrival to puncture (174 vs 125.5 min; p=0.002) and time from hospital arrival to reperfusion (213 vs 172 min; p=0.047) were significantly prolonged in the pandemic group compared with the pre-pandemic group. The rate of successful reperfusion was not significantly different between the two groups (85.7% (n=18) vs 88.2% (n=30); OR 0.971, 95% CI 0.785 to 1.203; p=1.000).

Conclusion The results of this study suggest a proper PCS algorithm which combines the COVID-19 screening and protection measures could decrease the impact of the disease on the clinical outcomes of EVT for AIS patients to the lowest extent possible during the pandemic.

  • thrombectomy
  • stroke
  • intervention

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/neurintsurg-2020-016177

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    Footnotes

    • BY and TW contributed equally.

    • Contributors All authors of this work met the International Committee of Medical Journal Editors criteria for authorship and made substantial contributions to the conception and design, acquisition of data, analysis and interpretation of data, drafting, critical revising, and final approval of this manuscript.

    • Funding This work was supported by the National Key Research and Development Project (2016YFC1301703) and the Beijing Scientific and Technologic Project (D161100003816002).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval Approved by the Ethics Committee of Xuanwu Hospital ([2020]005).

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

    • Data availability statement The data used to support the findings of this study are available from the corresponding author upon request.

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