Role of interventional radiology in the treatment of COVID-19 patients: Early experience from an epicenter

Abstract

Objective To highlight the role of interventional radiology (IR) in the treatment of patients hospitalized with coronavirus disease 2019 (COVID-19). Methods Retrospective review of hospitalized patients who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and had one or more IR procedures at a tertiary referral hospital in New York City during a 6-week period in April and May of 2020. Results Of the 724 patients admitted with COVID-19, 92 (12.7%) underwent 124 interventional radiology procedures (79.8% in IR suite, 20.2% at bedside). The median age of IR patients was 63 years (range 24–86 years); 39.1% were female; 35.9% in the intensive care unit. The most commonly performed IR procedures were central venous catheter placement (31.5%), inferior vena cava filter placement (9.7%), angiography/embolization (4.8%), gastrostomy tube placement (9.7%), image-guided biopsy (10.5%), abscess drainage (9.7%), and cholecystostomy tube placement (6.5%). Thoracentesis/chest tube placement and nephrostomy tube placement were also performed as well as catheter-directed thrombolysis of massive pulmonary embolism and thrombectomy of deep vein thrombosis. General anesthesia (10.5%), monitored anesthesia care (18.5%), moderate sedation (29.8%), or local anesthetic (41.1%) was utilized. There were 3 (2.4%) minor complications (SIR adverse event class B), 1 (0.8%) major complication (class C), and no procedure-related death. With a median follow-up of 4.3 months, 1.1% of patients remain hospitalized, 16.3% died, and 82.6% were discharged. Conclusion Interventional radiology participated in the care of hospitalized COVID-19 patients by performing a wide variety of necessary procedures.

Impact of the first year of the COVID-19 pandemic on an interventional radiology unit

“…Finally, Lee et al 16 highlighted the role of interventional radiology in the treatment of patients hospitalised with COVID-19; they conducted a retrospective review of hospitalised patients positive for COVID who underwent some sort of interventional procedure at a leading tertiary hospital in New York City. After a mean follow-up of 4.3 months, 1.1% of patients remained hospitalised, 16.3% died and 82.6% were discharged.…”

Single Center Experience in Vascular and Endovascular Surgery during the COVID-19 Pandemic: Walking on the Icy Road

“…[4,6] The patients in the interventional group were evaluated retrospectively in terms of comorbid diseases, type of interventional or endovascular treatments, duration of procedure, type of anesthesia, and complications. [7] The demographic data and procedural details of both groups are shown in Table 1 and Table 2.…”

“…If the patients were diagnosed with acute renal failure (ARF) during outpatient or ward follow-ups, a temporary hemodialysis (HD) catheter was placed under local anesthesia and under sterile conditions at the bedside or in the outpatient operating room. [7] A bedside temporary HD catheter was placed in patients who developed ARF during intensive care unit follow-ups. Permanent tunneled HD catheter was placed in the operating room under fluoroscopy and under local anesthesia in patients who developed chronic renal failure (CRF) and needed long-term dialysis.…”

VIP Patients in Interventional Radiology: Do Some Patients Deserve “Better” Care?

“…23 The impact of the pandemic on IR has not only been realized through reduced access to hospital beds for patients who need admission after a procedure, but also in the treatment of patients with COVID-related complications, such as pulmonary emboli. [24][25][26] These scenarios are vulnerable to VIP status, which impacts triaging and prioritizing patients both with and without COVID-19, creating an ethical quandary for providers. The risk of moral injury may be particularly high when there are conflicting perceptions of a patient as a VIP, disagreement among team members regarding appropriate management, or perceived negative impact on non-VIP patients.…”