The Impact of the Pandemic on Acute Ischaemic Stroke Endovascular Treatment from a Multidisciplinary Perspective: A Nonsystematic Review

Milda Grigonyte, Agne Kraujelyte, Elija Januskeviciute, Giedrius Semys, Oresta Kriukelyte, Egle Kontrimaviciute, Nomeda Rima Valeviciene and Dalius Jatuzis
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Milda Grigonyte: Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania
Agne Kraujelyte: Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania
Elija Januskeviciute: Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania
Giedrius Semys: Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania
Oresta Kriukelyte: Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania
Egle Kontrimaviciute: Clinic of Anaesthesiology and Intensive Care, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania
Nomeda Rima Valeviciene: Department of Radiology, Nuclear Medicine and Medical Physics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania
Dalius Jatuzis: Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania

IJERPH, 2021, vol. 18, issue 18, 1-12

Abstract: Background: At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, reduced admissions for cerebrovascular events were identified, but acute ischaemic stroke (AIS) has remained one of the leading causes of death and disability for many years. The aim of this article is to review current literature data for multidisciplinary team (MDT) coordination, rational management of resources and facilities, ensuring timely medical care for large vessel occlusion (LVO) AIS patients requiring endovascular treatment during the pandemic. Methods: A detailed literature search was performed in Google Scholar and PubMed databases using these keywords and their combinations: acute ischaemic stroke, emergency, anaesthesia, airway management, mechanical thrombectomy, endovascular treatment, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19. Published studies and guidelines from inception to April 2021 were screened. The following nonsystematic review is based on a comprehensive literature search of available data, wherein 59 were chosen for detailed analysis. Results: The pandemic has an impact on every aspect of AIS care, including prethrombectomy, intraprocedural and post-thrombectomy issues. Main challenges include institutional preparedness, increased number of AIS patients with multiorgan involvement, different work coordination principles and considerations about preferred anaesthetic technique. Care of these patients is led by MDT and nonoperating room anaesthesia (NORA) principles are applied. Conclusions: Adequate management of AIS patients requiring mechanical thrombectomy during the pandemic is of paramount importance to maximise the benefit of the endovascular procedure. MDT work and familiarity with NORA principles decrease the negative impact of the disease on the clinical outcomes for AIS patients.

Keywords: acute ischaemic stroke; emergency; anaesthesia; airway management; mechanical thrombectomy; SARS-CoV-2; COVID-19 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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