Introduction The coronavirus disease 2019 (COVID-19) has created unprecedented challenges on the healthcare system. The aim of this multi-centre study was to measure the impact of COVID-19 on IR services in the UK. Material and Methods Retrospective cross-sectional study of IR practice in six UK centres during the COVID-19 pandemic was carried out. All therapeutic IR procedures were identified using the respective hospital radiology information systems and COVID-19 status found on the hospital patient record systems. The total number of therapeutic IR procedures was recorded over two time periods, 25/03/2019–21/04/2019 (control group) and 30/03/2020–26/04/2020 (COVID-19 group). The data points collected were: procedure type, aerosol-generating nature, acute or elective case, modality used, in- or out-of-hours case and whether the procedure was done at the bedside (portable). Results A 31% decrease in overall number of IR procedures was observed during COVID-19 compared to the control group (1363 cases vs 942 cases); however, the acute work decreased by only 0.5%. An increase in out-of-hours work by 10% was observed. COVID-19 was suspected or laboratory proved in 9.9% of cases (n = 93), and 15% of total cases (n = 141) were classed as aerosol-generating procedures. A 66% rise in cholecystostomy was noted during COVID-19. Image-guided ablation, IVC filters, aortic stent grafting and visceral vascular stenting had the greatest % decreases in practice during COVID-19, with 91.7%, 83.3%, 80.8% and 80.2% decreases, respectively. Conclusion During the global pandemic, IR has continued to provide emergency and elective treatment highlighting the adaptability of IR in supporting other specialties.
Background: Due to high risk of massive blood loss of traumatic injury of dural venous sinus at the time of trauma or emergency operation leading to high mortality rate, we considered the appropriate methods that are most essential in treatment of depressed skull fracture over dural venous sinus to decrease mortality rate as much as possible. Aim of Study: For assessment of surgical interference in cases of depressed skull bone fracture with dural venous sinuses injury is it risky with high mortality rate or can be done safely with different methods or it is better to be conserve than surgical interference. Patients and Methods: Twenty two patients with transsinus compound depressed skull fracture were reviewed retrospectively who presented to emergency department in Aswan university hospitals between January 2014 and June 2018. All patients submitted to computed tomography scan (CT scan) for assessment of fracture site, size and relation to dural venous sinuses. Results: Twenty two patients with a dural venous sinus injury from severe head injuries who had been treated upon in the two hospitals were reviewed retrospectively. There were 18 males and 4 females patients. All cases underwent surgical interference ,with mortality rate (22.73%) of operated cases, due to massive blood loss intraoperative and uncontrolled sinus repair and hypovolemic shock. Conclusion: When there is depressed skull fracture penetrating the sinus, so we will take care for possibility of massive blood loss and uncontrolled repair of injured sinus, and we face a high mortality case. The surgeon should be prepared for the possibility of potentially fatal venous sinus injury, and so, conservative treatment better than surgical intervention of penetrating cases of dural venous sinus injuries as much as possible.
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