COVID-19 and neurointerventional service worldwide: a survey of the European Society of Minimally Invasive Neurological Therapy (ESMINT), the Society of NeuroInterventional Surgery (SNIS), the Sociedad Iberolatinoamericana de Neuroradiologia Diagnostica y Terapeutica (SILAN), the Society of Vascular and Interventional Neurology (SVIN), and the World Federation of Interventional and Therapeutic Neuroradiology (WFITN)

Abstract

BackgroundThis survey was focused on the provision of neurointerventional services, the current practices of managing patients under COVID-19 conditions, and the expectations for the future.MethodsInvitations for this survey were sent out as a collaborative effort of the European Society of Minimally Invasive Neurological Therapy (ESMINT), the Society of NeuroInterventional Surgery (SNIS), the Sociedad Iberolatinoamericana de Neuroradiologia Diagnostica y Terapeutica (SILAN), the Society of Vascular and Interventional Neurology (SVIN), and the World Federation of Interventional and Therapeutic Neuroradiology (WFITN).ResultsOverall, 475 participants from 61 countries responded (six from Africa (1%), 81 from Asia (17%), 156 from Europe (33%), 53 from Latin America (11%), and 172 from North America (11%)). The majority of participants (96%) reported being able to provide emergency services, though 26% of these reported limited resources. A decrease in emergency procedures was reported by 69% of participants (52% in ischemic and hemorrhagic stroke, 11% ischemic, and 6% hemorrhagic stroke alone). Only 4% reported an increase in emergency cases. The emerging need for social distancing and the rapid adoption of remote communication was reflected in the interest in establishing case discussion forums (43%), general online forums (37%), and access to angio video streaming for live mentoring and support (33%).ConclusionNeurointerventional emergency services are available in almost all centers, while the number of emergency patients is markedly decreased. Half of the participants have abandoned neurointerventions in non-emergent situations. There are considerable variations in the management of neurointerventions and in the expectations for the future.

Case Volumes and Perioperative Coronavirus Disease 2019 Incidence in Neurosurgical Patients During a Pandemic: Experiences at Two Tertiary Care Centers in Washington, DC

“…Fiehler et al. 19 reported the results from an international survey, demonstrating a significant decrease in emergent neurointerventional volume reported by 69% of the responders. We did not find such a decrease in our study.…”

Neurointervention in the 2020s: Where are We Going?

“…Remote mentoring is another highly desirable development that will probably soon find its way into clinical routine, partly because one-on-one/in person teaching has become very challenging, if not impossible, during the COVID-19 pandemic. This has led to a dramatic increase in demand for online teaching resources, virtual discussion forums and remote mentoring [ 29 ]. Recent studies have already shown the feasibility and safety of remote live streaming support for emergency neurointerventional procedures, such as mechanical thrombectomy [ 30 ].…”

International teleproctoring in neurointerventional surgery and its potential impact on clinical trials in the era of COVID-19: legal and technical considerations

“…Results of a survey was conducted among neurointerventionalists from all five continents at the beginning of the COVID-19 pandemic showed that 33% of the respondents were in favor of 24/7 availability of remote physician supervision through live stream platforms. This technology was deemed particularly necessary for junior team members undergoing complex procedures without the possibility of supervision by senior partners either due to epidemic mitigation policies or to such members falling ill. 17 …”

“…5 Results of a survey was conducted among neurointerventionalists from all five continents at the beginning of the COVID-19 pandemic showed that 33% of the respondents were in favor of 24/7 availability of remote physician supervision through live stream platforms. This technology was deemed particularly necessary for junior team members undergoing complex procedures without the possibility of supervision by senior partners either due to epidemic mitigation policies or to such members falling ill. 17 Remote proctoring for neurointerventional procedures had been first investigated by Bechstein et al in 2019. 18 The authors analyzed 36 thrombectomy procedures performed on an in vitro stroke model using vascular replica by nonsubspecialty trained interventional radiologists either with on-site supervision or with teleproctoring.…”