Carotid Artery Operation Delay During the Covid-19 Pandemic: Results of a Multicenter International Study.

Autor:	Kabeil M; Division of Vascular Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO., Wohlauer MV; Division of Vascular Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO. Electronic address: max.wohlauer@cuanschutz.edu., D'Oria M; Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste ASUGI, Trieste, Italy., Khetarpaul V; Department of Surgery, Section of Vascular Surgery, Washington University School of Medicine, St. Louis, MO., Gillette R; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO., Moore E; Division of Vascular Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO., Colborn K; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO., Cuff RF; Spectrum Health, Grand Rapids, MO., O'Banion LA; Department of Surgery, University of California San Francisco (UCSF) Fresno, Fresno, CA., Koleilat I; Department of Surgery, RWJBH Community Medical Center, Toms River, NJ., Aziz F; Division of Vascular Surgery, Department of Surgery, Penn State University, State College, PA., Mouawad NJ; McLaren Health System, Bay City, MO.
Jazyk:	angličtina
Zdroj:	Annals of vascular surgery [Ann Vasc Surg] 2023 Oct; Vol. 96, pp. 44-56. Date of Electronic Publication: 2023 Jun 23.
DOI:	10.1016/j.avsg.2023.05.041
Abstrakt:	Background: To measure the impact of the COVID-19 pandemic on the management of patients with carotid artery stenosis. Methods: We prospectively collected data from 25 centers (19 centers in the United States and 6 centers internationally) on postponed carotid artery operations between March 2020 and January 2022. We describe the characteristics of these patients and their planned operations, along with outcomes including mortality and neurological deterioration during the period of operative delay due to the COVID-19 pandemic. Results: A total of 1,220 vascular operations were postponed during the pandemic, of them 96 patients presented with significant carotid stenosis (median stenosis of 71%; interquartile range; 70-80) and 80% of them were planned for carotid endarterectomy. Most patients were asymptomatic (69%), and 31% of patients were symptomatic (16% of patients had a stroke, 15% of patients had a transient ischemic attack, and 1% of patients experienced amaurosis fugax). The median length of surgical delay was 71 days (interquartile range: 45.5, 115.5). At the data entry time, 62% of patients had their carotid operations postponed and successfully completed. Most postponements (72%) were due to institutional policies aimed at resource conservation. During the delay, no patient decompensated or required an urgent operation. A total of 5 patients (5%) with carotid stenosis died while awaiting operations due to COVID-19. Conclusions: Our study of a cohort of patients with carotid artery stenosis who underwent a median delay of 71 days during the COVID-19 pandemic showed a disparate operation delay between US regions and internationally, most postponements were due to hospital policy, and none of the patients deteriorated or required an emergency surgery during the delay. (Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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