Progression of Changes in Vascular Surgery Practices during the Novel Corona Virus SARS-CoV-2 Pandemic

Bath, Jonathan; Aziz, Faisal; Smeds, Matthew R.

doi:10.1016/j.avsg.2021.03.002

Cited by 5 publications

(2 citation statements)

References 27 publications

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“…Las patologías y consultas no emergentes por causas vasculares se vieron disminuidas y aplazadas en la etapa temprana de la pandemia 13,14 , al igual que lo encontrado en la población de esta serie, a los pacientes de todo el mundo se les agendaron citas virtuales durante la pandemia con el fin de evitar el contacto estrecho y reducir así la posibilidad de contagio por COVID-19 14 .…”

Section: Discussionunclassified

Salud vascular y pandemia: percepción del paciente en la consulta vascular ambulatoria durante COVID-19

López-Uribe¹,

Luna²,

Correa³

et al. 2021

RMA

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Antecedentes: El COVID-19 desplazó la atención de las enfermedades no urgentes, aumentando la percepción del deterioro en salud, las quejas por demoras en la atención e insatisfacción con la consulta virtual. Objetivo: Determinar la percepción del paciente en la salud vascular y el uso de telemedicina durante la pandemia. Material y métodos: Encuesta en 142 pacientes de consulta de cirugía vascular entre abril y junio de 2021. Resultados: La mayoría tenía enfermedad venosa (EV) seguida de arterial (EA) y linfática (EL). Los pacientes con EA empeoraron los síntomas, mientras que los de EV o EL permanecieron igual. Menos de la mitad tuvo miedo a la atención médica presencial o la suspendieron voluntariamente por temor al contagio de COVID-19. Hubo reprogramación oportuna y satisfacción con la consulta virtual en la mayoría, sin repercusión en la percepción final del estado de salud vascular. Conclusión: Se encontró un aumento de síntomas y disminución en la oportunidad de atención, sin impacto significativo en la salud vascular o complicaciones.

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Section: Discussionunclassified

Salud vascular y pandemia: percepción del paciente en la consulta vascular ambulatoria durante COVID-19

López-Uribe¹,

Luna²,

Correa³

et al. 2021

RMA

View full text Add to dashboard Cite

show abstract

“…However, during this period every vascular surgeon had treated at least one patient affected by COVID-19 with thromboembolic events, most commonly acute limb ischemia or deep venous thrombosis [6,7]. The incidence of acute limb ischemia (ALI) increased, and the occurrences were mainly in patients who were COVID-19 positive [8].…”

Section: Introductionmentioning

confidence: 99%

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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Editor's Choice – Update of the European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia in Light of the COVID-19 Pandemic, Based on a Scoping Review of the Literature

Jongkind

Earnshaw

Gonçalves

et al. 2022

European Journal of Vascular and Endovascular Surgery

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Objectives Perform a scoping review how COVID-19 patients are affected by acute limb ischaemia (ALI). Evaluate the recommendations of the 2020 ESVS ALI Guidelines for these patients. Methods Research questions were defined, followed by a systematic literature search according to the PRISMA guideline. Abstracts and unpublished literature were not included. The definition of ALI accords to ESVS guidelines. Results Most identified papers were case reports or case series; population-based data and data from randomised controlled trials were also identified, 114 unique and relevant papers were retrieved. Data were conflicting concerning whether the incidence of ALI increased, or remained unchanged, during the pandemic. Case reports and series reported ALI in patients who were younger and healthier than usual, and a greater proportion affecting the upper limb. Whether this is coincidental remains uncertain. The proportion of men/women affected seems unchanged. Most reported cases were in hospitalised patients with severe COVID-19. Patients with ALI as their first manifestation of COVID-19 were reported. Patients with ALI have a worse outcome if they have a simultaneous COVID-19 infection. High levels of D-dimer may predict the occurrence of arterial thromboembolic events in patients with COVID-19. Heparin resistance was observed. Anticoagulation should be given to hospitalized COVID-19 patients in prophylactic dosage. Most of the treatment recommendations of the ESVS Guidelines remained relevant, but the following were modified regarding COVID-19 patients with ALI: 1) CTA imaging before revascularisation should include the entire aorta and iliac arteries. 2) There should be a high index of suspicion, early testing for COVID-19 infection and protective measures are advised. 3) Preferential use of local or locoregional anaesthesia during revascularisation. Conclusion Although the epidemiology of ALI has changed during the pandemic, the recommendations of the ESVS ALI Guidelines remain valid. The above mentioned minor modifications should be considered in COVID-19 patients with ALI.

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Progression of Changes in Vascular Surgery Practices during the Novel Corona Virus SARS-CoV-2 Pandemic

Cited by 5 publications

References 27 publications

Salud vascular y pandemia: percepción del paciente en la consulta vascular ambulatoria durante COVID-19

Salud vascular y pandemia: percepción del paciente en la consulta vascular ambulatoria durante COVID-19

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

Editor's Choice – Update of the European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia in Light of the COVID-19 Pandemic, Based on a Scoping Review of the Literature

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