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Original research
COVID-19 and neurointerventional service worldwide: a survey of the European Society of Minimally Invasive Neurological Therapy (ESMINT), the Society of NeuroInterventional Surgery (SNIS), the Sociedad Iberolatinoamericana de Neuroradiologia Diagnostica y Terapeutica (SILAN), the Society of Vascular and Interventional Neurology (SVIN), and the World Federation of Interventional and Therapeutic Neuroradiology (WFITN)
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  1. Jens Fiehler1,
  2. Patrick Brouwer2,
  3. Carlos Díaz3,
  4. Joshua A Hirsch4,
  5. Zsolt Kulcsar5,
  6. David Liebeskind6,
  7. Italo Linfante7,
  8. Pedro Lylyk8,
  9. William J Mack9,
  10. James Milburn10,
  11. Raul Nogueira11,
  12. Darren B Orbach12,
  13. José Manuel Manuel Pumar13,
  14. Michihiro Tanaka14,
  15. Allan Taylor15
  1. 1 Department of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, Germany
  2. 2 Neuroradiology, Karolinska Universitetssjukhuset, Stockholm, Stockholmslän, Sweden
  3. 3 Radiology, Universidad de Antioquia, Medellin, Antioquia, Colombia
  4. 4 NeuroEndovascular Program, Massachusetts General Hospital, Boston, Massachusetts, USA
  5. 5 Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
  6. 6 Neurology, UCLA, Los Angeles, California, USA
  7. 7 Baptist Cardiac and Vascular Institute, Miami, Florida, USA
  8. 8 Interventional Neuroradiology, Clinical Institute ENERI, Buenos Aires, Argentina
  9. 9 Neurosurgery, University of Southern California, Los Angeles, California, USA
  10. 10 Radiology, Ochsner Medical System, New Orleans, Louisiana, USA
  11. 11 Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
  12. 12 Neurointerventional Rdiology, Boston Children's Hospital, Boston, Massachusetts, USA
  13. 13 Neuroradiology, Hospital Clinico Universitario, Santiago de Compostela, Spain
  14. 14 Neurosurgery, Kameda Medical Center, Kamogawa, Chiba, Japan
  15. 15 Neurosurgery, University of Cape Town, Cape Town, W Cape, South Africa
  1. Correspondence to Dr Jens Fiehler, Dept. of Neuroradiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg, Germany; fiehler{at}uke.de

Abstract

Background This survey was focused on the provision of neurointerventional services, the current practices of managing patients under COVID-19 conditions, and the expectations for the future.

Methods Invitations for this survey were sent out as a collaborative effort of the European Society of Minimally Invasive Neurological Therapy (ESMINT), the Society of NeuroInterventional Surgery (SNIS), the Sociedad Iberolatinoamericana de Neuroradiologia Diagnostica y Terapeutica (SILAN), the Society of Vascular and Interventional Neurology (SVIN), and the World Federation of Interventional and Therapeutic Neuroradiology (WFITN).

Results Overall, 475 participants from 61 countries responded (six from Africa (1%), 81 from Asia (17%), 156 from Europe (33%), 53 from Latin America (11%), and 172 from North America (11%)). The majority of participants (96%) reported being able to provide emergency services, though 26% of these reported limited resources. A decrease in emergency procedures was reported by 69% of participants (52% in ischemic and hemorrhagic stroke, 11% ischemic, and 6% hemorrhagic stroke alone). Only 4% reported an increase in emergency cases. The emerging need for social distancing and the rapid adoption of remote communication was reflected in the interest in establishing case discussion forums (43%), general online forums (37%), and access to angio video streaming for live mentoring and support (33%).

Conclusion Neurointerventional emergency services are available in almost all centers, while the number of emergency patients is markedly decreased. Half of the participants have abandoned neurointerventions in non-emergent situations. There are considerable variations in the management of neurointerventions and in the expectations for the future.

  • stroke
  • intervention
  • standards
  • political
  • thrombectomy

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Footnotes

  • Twitter @CDiazNeuroInter, @JoshuaAHirsch, @italolinfante, @docroc99

  • Contributors JF: Designing the research plan, conducting the data analysis and drafting the manuscript, PB, CD, JAH, ZK, DL, IL, PL, WJ, JM, RN, DBO, JMMP, MT, AT: Critically revising the manuscript.

  • 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.

  • Map disclaimer The depiction of boundaries on this map does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. This map is provided without any warranty of any kind, either express or implied.

  • Competing interests Consultancy: Acandis, Bayer, Boehringer Ingelheim, Cerenovus, Medtronic, Microvention, Stryker, CD: Proctor Medtronic. DL: Consultant to Cerenovus, Genentech, Stryker, Medtronic as Imaging Core Lab. WJ: Consultancy: Rebound Therapeutics, Integra, Viseon, Imperative Care, Medtronic, Q’Apel, Stream Biomedical, Spartan Micro; Investor: Cerebrotech, Endostream, Viseon, Rebound, and Spartan Micro, JMM: Disclosures are: Penumbra: speaker’s bureau, Stryker: Consultant.

  • Patient consent for publication Not required.

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

  • Data availability statement Data are available upon reasonable request. No patient data included.

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