Blog Viewer

Mechanical Thrombectomy in the Era of the COVID-19 Pandemic: Emergency Preparedness for Neuroscience Teams

By Currents Editor posted 06-03-2020 08:15

  

Stroke  (04/29/20) doi: 10.1161/STROKEAHA.120.03010

Nguyen, Thanh N.; Abdalkader, Mohamad; Jovin, Tudor G.; et al.

https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.120.030100

 

The Society of Vascular and Interventional Neurology (SVIN) has released a guidance statement on acute ischemic large vessel occlusion strokes in an effort to reduce the transmission of COVID-19 and optimize healthcare resources. The document divides treatment for acute stroke into four phases: prehospital to the emergency department, prethrombectomy, thrombectomy intraprocedure, and post-reperfusion therapy. SVIN’s recommendations include screening every acute stroke patient for symptoms and signs of COVID-19 following local protocols; using remote telestroke technology to obtain history and perform neurological examination, if available; and if there is a positive screening for COVID-19, having the patient wear a surgical mask and immediately placing the individual in a negative pressure room in the emergency department. Additional suggestions include preparing all procedural elements in the room prior to patient arrival; considering low-dose chest computerized tomography (CT) at the same time as the performance of CT head and CT angiography head and neck to facilitate diagnosis of COVID-19; alerting the anesthiology provider early of patient with confirmed or suspected infection; and keeping staff to a minimum during the thrombectomy, both to reduce the risk of exposure and conserve protective equipment. “Every opportunity and detail to recalibrate our acute neurological workflow to protect our frontline healthcare workers, our families, our colleagues, and our patients should be sought, implemented, and adapted to a resource-constrained environment,” the researchers write. “It is incumbent upon us to protect each other so that we are not unknowingly exposed or  spread  to  our  most  vulnerable  patients,  while  at  the  same  time, providing optimal care, patient safety, and access for our patients  with  stroke.”

#LiteratureWatch
#COVID-19

​​
FURTHER READING
Claiborne Johnston, Pierre Amarenco, et al. for the THALES investigators.Ticagrelor and Aspirin or Aspirin Alone in Acute Ischemic Stroke or TIA. N Engl J Med   2020;383:207-17.
DOI: 10.1056/NEJMoa1916870
 Reviewed by Sanjeev Sivakumar,MD Read the article .*   *You will need to log in ...
Kwak HS, Park JS. Mechanical Thrombectomy in Basilar Artery Occlusion: Clinical Outcomes Related to Posterior Circulation Collateral Score.  Stroke . 2020;51(7):2045-2050. doi:10.1161/STROKEAHA.120.029861 Reviewed by Shannon Hextrum, MD Read the article .*   *You will need to log in to ...
By Michelle Schober, MD James Baldwin said, “Not everything that is faced can be changed, but nothing can change until it is faced.” Many who previously doubted the existence of racial inequity in our society now finally accept it as a grave problem. Sadly, many of the newly convinced fail to internalize ...