Ischemic Stroke and Coronavirus Infection: Complications of Endovascular Thrombectomy

Abstract

The objective of our study was to compare complications of endovascular thrombectomy (EVT), in ischemic stroke (IS) patients admitted with or without COVID-19 to hospitals converted to deliver COVID-19-specific care. Materials and methods. A retrospective analysis of 817 clinical cases of IS patients aged 25–99 years treated in regional vascular centers of Saint Petersburg from 1 January to 31 December 2021, with confirmed thrombotic occlusion of cerebral vessels and subsequent EVT intervention. Results. The EVT number per bed was significantly higher (1.6) in the non-converted hospitals compared to the COVID-19-converted hospitals (0.49; p 0.001). At the same time, more intraoperative complications (12% vs. 7.1%; p = 0.03) were reported in non-converted hospitals compared to COVID-19 converted hospitals. The likelihood of a favorable functional outcome was higher in younger patients with less severe neurological deficits on admission and without concomitant COVID-19 or post-operative complications. Conclusion. COVID-19 is a limiting factor for the effectiveness of an IS treatment in patients who underwent EVT, affecting thereby functional outcomes in this cohort of patients. The impact of the COVID-19 pandemic on intra-operative EVT complication rate was associated with disrupted triage of IS patients and an uneven distribution of the workload among surgical teams in the city hospitals.

Keywords

• ischemic stroke
• endovascular thrombectomy
• cerebral artery thrombosis
• novel coronavirus infection
• complications