Changes in vascular surgery practice patterns 1 year into the COVID-19 pandemic

Feliz, Jessica D.; Ozaki, C. Keith; Belkin, Michael; Hussain, Mohamad A.

doi:10.1016/j.jvs.2021.04.022

Cited by 3 publications

(4 citation statements)

References 4 publications

(6 reference statements)

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“…This mainly due to an increase in amputations for Fontaine 4. As in earlier publications this is ascribed to a delay in presentation in a more recent report ( 10 ). Inverse to the number of amputations we saw a reduction in the number of femoro-popliteal bypasses, an operation typically performed in patients with Fontaine 4.…”

Section: Discussionsupporting

confidence: 69%

“…Inverse to the number of amputations we saw a reduction in the number of femoro-popliteal bypasses, an operation typically performed in patients with Fontaine 4. This reduction in lower extremity revascularization was observed by some ( 10 ) but not by other authors ( 1 , 2 ). Interestingly, the number of interventions for ALI was not significantly altered in the present study.…”

Section: Discussionmentioning

confidence: 52%

“…In Sweden no significant reduction in the number of vascular interventions was observed when comparing 2020 to the previous years ( 9 ), taking into account that they had no formal period of lockdown. Reports from Massachusetts observe a decline in procedures between 18 March 2020 and the end of the year, even after resumption of normal services ( 10 ). Initiatives like the Vascular Surgery COVID-19 Collaborative (VASCC) ( 11 ) and the COVID-19 Vascular Service (COVER) study ( 12 ) will hopefully further elucidate the impact of de SARS-CoV-2 pandemic on vascular practices worldwide.…”

Section: Discussionmentioning

confidence: 99%

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Treating Peripheral Arterial Occlusive Disease and Acute Limb Ischemia During a COVID-19 Pandemic in 2020

Exelmans

Knaapen

Winter

et al. 2022

Annals of Vascular Surgery

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Objective For many surgeons the outbreak of SARS-CoV-2 meant a downscaling of surgical interventions. The aim of this study was to investigate the impact of the measures taken on the care for patients with peripheral arterial disease (PAOD) and acute limb ischemia (ALI). Methods A retrospective analysis of the vascular practices of two major teaching hospitals in the Netherlands was performed. All interventions and outpatient visits for PAOD or ALI in 2020 were included. Patients treated in 2018 and 2019 were to serve as a control group. Data were analysed using descriptive statistics. Results In 2020, a total of 1513 procedures were performed for PAOD or ALI. This did not differ significantly from previous years. Overall, Fontaine 2 and 4 were the most frequent indications for intervention. A significant increase in the number of major amputations was observed in 2020 compared to 2018 (p <0.01). This was mainly due to patients suffering from PAOD Fontaine 4. Inversely, a reduction in the number of femoro-popliteal bypasses was observed between 2020 and 2018. The number of outpatient visit due to Fontaine 2 was significantly lower in 2020 compared to 2018. Conclusion The vascular practices of our hospitals were minimally influenced by the measures taken due to the outbreak of SARS-CoV-2. There was an increase in the number of amputation but an enormous surge in patients presenting with critical limb ischemia was not observed.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Treating Peripheral Arterial Occlusive Disease and Acute Limb Ischemia During a COVID-19 Pandemic in 2020

Exelmans

Knaapen

Winter

et al. 2022

Annals of Vascular Surgery

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“…According to their study, venous pathology recorded the highest decrease, followed by endovascular procedures and aortic aneurysm repair. The only procedure registering an increase in the number of interventions during the pandemic was amputation, which increased by 7% ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 pandemic on Vascular Surgery Unit activity in Central Romania

Emil-Marian¹,

Reka²,

Adrian

et al. 2022

Front. Surg.

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The COVID-19 outbreak has placed substantial pressure on the medical systems worldwide. This study aimed to investigate the influence of the prepandemic vs. pandemic period on the activity of the Vascular Surgery Unit of a large emergency hospital in Eastern Europe. We performed a retrospective review of the vascular surgery cases admitted, comparing the statistics from the two time periods. We examined data of a total of 1,693 patients over the two periods. We report a 34.51% decrease in the surgical procedures performed during the pandemic period, with a disproportionate 80.6% decrease in the number of cases admitted with a diagnosis of venous insufficiency diagnosis and an increase of 67.21% in the number of patients admitted with acute arterial ischemia. Furthermore, individuals not classed as emergencies were delayed or denied surgical care. The number of nonurgent procedures conducted by our Vascular Surgery Unit decreased significantly, whereas the number of emergency surgeries increased. COVID-19′s effect is projected to have a long-term impact on how surgical treatments are provided in Romania.

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Symptomatic Popliteal Artery Aneurysms in Recently SARS-CoV-2-Infected Patients: The Microangiopathic Thrombosis That Undermines Treatment

et al. 2023

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Background: Arterial and venous thrombosis are complications in SARS-CoV-2-infected patients. The microangiopathic thrombosis in affected patients can compromise results in urgent limb revascularizations. Aim of our study is to report on the incidence of symptoms development in patients affected by popliteal artery aneurysm (PAA) and to analyze the effect of COVID-19 infection on outcomes. Methods: Data on patients surgically treated for PAA from the massive widespread of COVID-19 vaccine (March 2021) to March 2022 were prospectively collected. Factors considered for analysis were: presence of symptoms, aneurysm diameter and length, time from symptom onset and hospital referral, ongoing or recently COVID-19 infection. Outcomes measures were: death, amputation, and neurological deficit. Results: Between March 2021 and March 2022, 35 patients were surgically treated for PAA. Among them 15 referred to our hospital for symptomatic PAA and were urgently treated. Urgent treatments included both endovascular procedures and open surgeries. Nine out of 15 symptomatic patients had an ongoing or recently recovered COVID-19 infection. COVID-19 infection was strongly associated to symptoms development in patients affected by PAA and to surgical failure in those patients (OR 40, 95% CI 2.01–794.31, p = 0.005). Conclusion: In our series, presence of COVID-19 infection was strongly associated to ischemic symptoms onset and to complications after urgent treatment in symptomatic patients.

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Changes in vascular surgery practice patterns 1 year into the COVID-19 pandemic

Cited by 3 publications

References 4 publications

Treating Peripheral Arterial Occlusive Disease and Acute Limb Ischemia During a COVID-19 Pandemic in 2020

Treating Peripheral Arterial Occlusive Disease and Acute Limb Ischemia During a COVID-19 Pandemic in 2020

Impact of COVID-19 pandemic on Vascular Surgery Unit activity in Central Romania

Symptomatic Popliteal Artery Aneurysms in Recently SARS-CoV-2-Infected Patients: The Microangiopathic Thrombosis That Undermines Treatment

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