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1. Outcomes Following Vascular and Endovascular Procedures Performed During the First COVID-19 Pandemic Wave

Author

Panagiota Birmpili, Ruth A. Benson, Brenig Gwilym, Sandip Nandhra, Nina Al-Saadi, Graeme K. Ambler, Robert Blair, David Bosanquet, Nikesh Dattani, Louise Hitchman, Katherine Hurndall, Matthew Machin, Sarah Onida, Athanasios Saratzis, Joseph Shalhoub, Lauren Shelmerdine, Aminder A. Singh, Lauren, Shelmerdine, Aminder Anthony Singh, David C. Bosanquet, Rachael O. Forsythe, George Dovell, Ryan Preece, Chris Imray, Sonia Kandola, Adam Johnson, Andrew Choong, Jun Jie Ng, Sarah Aitken, Jana-Lee Moss, Efthymios Beropoulis, Konstantinos Stavroulakis, Fabrico Santiago, Amr Abdelhaliem, Aseel Abuduruk, Thomas M. Aherne, Hazem Ahmed, Sarah J. Aitken, Tasleem Akhtar, Bekir B. Akkaya, Julien Al Shakarchi, Abdeljawad J. Algasi, Musaad AlHamzah, Ahmed A. Alhumiad, Bernard Allard, Meshal Almeshal, Faris Alomran, Reem N. AlRakaf, Mohamed Altabal, Nishath Altaf, Abdulmajeed H. Altoijry, Talal Altuwaijri, Nasser Alwehaibi, Sara J. Anderson Baker, Domenico Angiletta, Afroditi Antoniou, George A. Antoniou, Libnah L. Areias, James Ashcroft, Noel Atkinson, Doaa Attia, Lukas Attwell, Mohammed A. Azab, Omar Aziz, Ahmed Y. Azzam, Christos Bakoyiannis, Hashem Barakat, Khalid Bashar, Ruth Battersby, K.S. Benaragama, Ahmed T.S. BenGhatnsh, Nikolaos Bessias, Resya Bhakthavalsalan, Shagran Binkhamis, Roshan Bootun, Emily Boyle, Ion Buga, Martin Catterson, Jennifer L. Chambers, Karishma Chandarana, Alexandros Charalabopoulos, Gabriella Charlton, Stephen W.K. Cheng, Natasha Chinai, Asad J. Choudhry, Annie Clothier, Tina U. Cohnert, Chloe Coleman, Michael Costanza, Patrick A. Coughlin, James Coulston, James Cragg, Katy Darvall, Emma M. Davies, Huw Davies, Claire Dawkins, Joseph A. Dawson, Anastasia Dean, Bedanta S. Dhal, Andrew Duncan, Mark Edwards, Bridget Egan, Mehdi El Amrani, Ahmed Elhadi, Muhammed Elhadi, Mohamed S. Eljareh, Ramy Elkady, Mohamed Elkawafi, Fatimah S. Elkhafeefi, Maysoon Elkwahad, Ibrahim A. Ellojli, Kareem ElSanhoury, Hazem Elsantawy, Khaled Elsayed, Raed M. Ennab, Owain Fisher, Robert Fitridge, Ronald L.G. Flumignan, Amy L. Fowler, Richard F. Galloway, John Gan, Andrew Garnham, Sotirios Georgopoulos, Tamer M.H. Ghatwary Tantawy, Ravi R. Goel, Mingzheng A. Goh, Tabitha Grainger, Nalaka Gunawansa, Eric Hammond, Joseph Hanna, Simon C. Hardy, Thomas J. Hardy, Gareth J. Harrison, Ahmed Hassanin, Andrew T. Hattam, Martin Hein, Hytham K.S. Hmaid, Kay Hon, Kaisor Iqbal, Hakkı Z. Iscan, Arda Isik, Doireann P. Joyce, Maciej Juszczak, Kiriaki Kakavia, Stavros Kakkos, Christos D. Karkos, Emmanuel Katsogridakis, Rana Khalil, Andrew I. Khallaf, Aazeb Khan, Manar Khashram, Samantha Khoo, Joseph Kilby, Beatrice Kuang, Ioanna Kyrou, Pierfrancesco Lapolla, Kai W. Leong, Eunice Lim, Ju-wei N. Liu, Dafydd Locker, Xun Luo, Oliver T.A. Lyons, Ragai R. Makar, Dimitris Maras, Emmeline A. Martin, Hayrettin L. Mavioglu, Dennis Mazingi, James McCaslin, David N. McClure, Kevin McKevitt, Lewis Meecham, Shreya Mehta, Fabrizio Minelli, Andrea Mingoli, Afroditi M. Mitka, Farag S. Mohamed, Hayley M. Moore, Rachael L. Morley, Konstantinos G. Moulakakis, Eustratia Mpaili, Ahmed Msherghi, Kamel Muhammad, Juanita Muller, Korana Musicki, Luis C.U. Nakano, Craig Nesbitt, Jonathan Nicholls, Andrew Nickinson, Thamer Nouh, Jose M.S. Nunag, Isaac K. Nyamekye, Michael J. Papanikolas, Theofanis T. Papas, Konstantinos O. Papazoglou, Sharath Paravastu, Noala Parr, Ketino Pasenidou, Fernando Picazo Pineda, Franklin Pond, Matthew A. Popplewell, Katarzyna Powezka, Daniela Prce, Sivaram Premnath, Raffaele Pulli, Hussein M.M. Rabee, Habibur P. Rahman, Nandhini Ravintharan, Andrés Reyes Valdivia, Toby Richards, Konstantinos Roditis, Alexander E.S. Rolls, Iain N. Roy, Hani Saeed, Prakash Saha, Alberto Saltiel, Paolo Sapienza, Emma Scott, Christopher N. Selvaraj, Atif Sharif, Simona Sica, Justinas Silickas, Gurkirat Singh, Ashwin Sivaharan, Yogeesan Sivakumaran, Pranav Somaiya, Gerry Stansby, Bethany M. Stavert, Abhilash Sudarsanam, Elizabeth Suthers, Helen Suttenwood, Ahmed Taha, Mohamed A.H. Taha, Siu C. Tam, Alethea M. Tang, Robert Tang, Dana Taran, Lawrence Tarusan, Myat S. Thet, Jacqueline Thomas, Sean Tierney, Konstantinos Tigkiropoulos, Giovanni Tinelli, Mahmoud M.H. Tolba, Hannah C. Travers, Ioannis Tsagkos, Yamume Tshomba, Paraskevi Tsiantoula, Christopher P. Twine, Berkay Ulker, Serap Ulusoy, Ertekin U. Unal, Vincent C. Varley, Thodur M. Vasudevan, Uyen G. Vo, Timothy Wagner, Stewart R. Walsh, Judy Wang, Jackie Wong, Sarah A. Warren, Chun L.P. Yih, Sergio Zacà, Adeel S. Zafar, Shady Zaki, and Ewa M. Zywicka

Subjects
Vascular surgery, COVID-19, Coronavirus, Mortality, Diseases of the circulatory (Cardiovascular) system, RC666-701, Surgery, RD1-811
Abstract

Objective: The first COVID-19 pandemic wave was a period of reduced surgical activity and redistribution of resources to only those with late stage or critical presentations. This Vascular and Endovascular Research Network COVID-19 Vascular Service (COVER) study aimed to describe the six-month outcomes of patients who underwent open surgery and or endovascular interventions for major vascular conditions during this period. Methods: In this international, multicentre, prospective, observational study, centres recruited consecutive patients undergoing vascular procedures over a 12-week period. The study opened in March 2020 and closed to recruitment in August 2020. Patient demographics, procedure details, and post-operative outcomes were collected on a secure online database. The reported outcomes at 30 days and six months were post-operative complications, re-interventions, and all cause in-hospital mortality rate. Multivariable logistic regression was used to assess factors associated with six-month mortality rate. Results: Data were collected on 3 150 vascular procedures, including 1 380 lower limb revascularisations, 609 amputations, 403 aortic, 289 carotid, and 469 other vascular interventions. The median age was 68 years (interquartile range 59, 76), 73.5% were men, and 1.7% had confirmed COVID-19 disease. The cumulative all cause in-hospital, 30-day, and six-month mortality rates were 9.1%, 10.4%, and 12.8%, respectively. The six-month mortality rate was 32.1% (95% CI 24.2–40.8%) in patients with confirmed COVID-19 compared with 12.0% (95% CI 10.8–13.2%) in those without. After adjustment, confirmed COVID-19 was associated with a three times higher odds of six-month death (adjusted OR 3.25, 95% CI 2.18–4.83). Increasing ASA grade (3–5 vs. 1–2), frailty scores 4–9, diabetes mellitus, and urgent and or immediate procedures were also independently associated with increased odds of death by six months, while statin use had a protective effect. Conclusion: During the first wave of the pandemic, the six-month mortality rate after vascular and endovascular procedures was higher compared with historic pre-pandemic studies and associated with COVID-19 disease.

Published
2024
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2. Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Author

Ruth A. Benson, Maria Antonella Ruffino, Sharon Chan, Patrick Coughlin, Ayoola Awopetu, Philip Stather, Tristan Lane, Dimitrios Theodosiou, Mohamed Abozeid Ahmed, Thodur Vasudevan, Mohammed Ibrahim, Faraj Al Maadany, Mohamed Eljareh, Fatimah Saad Alkhafeefi, Raphael Coscas, Ertekin Utku Ünal, Raffaele Pulli, Sergio Zacà, Domenico Angiletta, Thomas Kotsis, Magdy Moawad, Matteo Tozzi, Nikolaos Patelis, Andreas M. Lazaris, Jason Chuen, Alexander Croo, Elpiniki Tsolaki, Gladiol Zenunaj, Dhafer Kamal, Mahmoud MH. Tolba, Martin Maresch, Vipul Khetarpaul, Joseph Mills, Gaurav Gangwani, Mohamed Elahwal, Rana Khalil, Mohammed A. Azab, Anver Mahomed, Richard Whiston, Ummul Contractor, Davide Esposito, Carlo Pratesi, Elena Giacomelli, Martín Veras Troncoso, Stephane Elkouri, Flavia Gentile Johansson, Ilias Dodos, Marie Benezit, José Vidoedo, João Rocha-Neves, António Henrique Pereira-Neves, Marina Felicidade Dias-Neto, Ana Filipa Campos Jácome, Luis Loureiro, Ivone Silva, Rodrigo Garza-Herrera, Victor Canata, Charlotte Bezard, Kathryn Bowser, Jorge Felipe Tobar, Carlos Gomez Vera, Carolina Salinas Parra, Eugenia Lopez, Yvis Gadelha Serra, Juan Varela, Vanessa Rubio, Gerardo Victoria, Adam Johnson, Leigh Ann O’Banion, Ragai Makar, Tamer Ghatwary Tantawy, Martin Storck, Vincent Jongkind, Orwa falah, Olivia McBride, Arda Isik, Athanasios Papaioannou, Paulo Eduardo Ocke Reis, Umberto Marcello Bracale, Ellie Atkins, Giovanni Tinelli, Emma Scott, Lucy Wales, Ashwin Sivaharan, Georgia Priona, Craig Nesbitt, Tabitha Grainger, Lauren Shelmerdine, Patrick Chong, Adnan Bajwa, Luke Arwynck, Nancy Hadjievangelou, Ahmed Elbasty, Oscar Rubio, Michael Ricardo, Jorge H. Ulloa, Marcos Tarazona, Manuel Pabon, Georgios Pitoulias, Kevin Corless, Orestis Ioannidis, Oliver Friedrich, Isabelle Van Herzeele, Badri Vijaynagar, Tina Cohnert, Rachel Bell, Hayley Moore, Prakash Saha, Edward Gifford, Matti Laine, Adel Barkat, Christos Karkos, Lenny Suryani Binti Safri, Gabriel Buitron, Javier Del Castillo, Paul Carrera, Nilson Salinas, Rodrigo Bruno Biagioni, Sergio Benites, César Andrés Mafla, Putera Mas Pian, Pereira Albino, Ernesto Serrano, Andres Marin, Marco González, Marsha Foreroga, Alejandro Russo, Andrés Reyes, Daniel Guglielmone, Lorena Grillo, Ronald Flumignan, Francisco Gomez Palones, Pierre Galvagni Silveira, Rosnelifaizur Bin Ramely, Sara Edeiken, Ian Chetter, Lucy Green, Abhilash Sudarsanam, Oliver Lyons, Gary Lemmon, Richard Neville, Mariano Castelli, Carlos A. Hinojosa, Rubén Rodríguez Carvajal, Aksim Rivera, Peng Wong, Laura Drudi, Jeremy Perkins, Kishore Sieunarine, Doaa Attia, Mahmoud Atef, Lostoridis Eftychios, Fred Weaver, Leong Chuo Ren, Mohannad Alomari, Reda Jamjoom, Qusai Aljarrah, Ayman Abbas, Faris Alomran, Ambrish Kumar, Abdulmajeed Altoijri, Kareem T. ElSanhoury, Ahmed Alhumaid, Tamer Fekry, Raghuram Sekhar, Panagiotis Theodoridis, Theodoridis Panagiotis, Konstantinos Roditis, Paraskevi Tsiantoula, Afroditi Antoniou, Raphael Soler, Natasha Hasemaki, Efstratia Baili, Eustratia Mpaili, Bella Huasen, Tom Wallace, Andrew Duncan, Matthew Metcalfe, Kristyn Mannoia, Carlos F. Bechara, Nikolaos Tsilimparis, Nathan Aranson, David Riding, Mariano Palena, Ciarán McDonnell, Nicolas J. Mouawad, Shonda Banegas, Peter Rossi, Taohid Oshodi, Rodney Diaz, Rana Afifi, Shiva Dindyal, Ankur Thapar, Ali Kordzadeh, Gonzalo Pullas, Stephanie Lin, Chris Davies, Katy Darvall, Akio Kodama, Thushan Gooneratne, Nalaka Gunawansa, Alberto Munoz, Ng Jun Jie, Nicholas Bradley, Wissam Al-Jundi, Felicity Meyer, Cheong Lee, Martin Malina, Sophie Renton, Dennis Lui, Andrew Batchelder, Grzegorz Oszkinis, Antonio Freyrie, Jacopo Giordano, Nikolaos Saratzis, Konstantinos Tigkiropoulos, Stavridis Kyriakos, Guriy Popov, Muhammad Usman Cheema, Pierfrancesco Lapolla, Yih Chun Ling Patricia, Raed Ennab, Brant W. Ullery, Ketino Pasenidou, Jacky Tam, Gabriel Sidel, Vivek Vardhan Jayaprakash, Lisa Bennett, Simon Hardy, Emma Davies, Sara Baker, Lasantha Wijesinghe, Adam Tam, Ken McCune, Manik Chana, Chris Lowe, Aaron Goh, Katarzyna Powezka, Ioanna Kyrou, Nishath Altaf, Denis Harkin, Hannah Travers, James Cragg, Atif sharif, Tasleem Akhtar, José Antonio Chávez, Claudia Ordonez, Martin Mazzurco, Edward Choke, Imran Asghar, Virginia Summerour, Paul Dunlop, Rachel Morley, Thomas Hardy, Paul Bevis, Robert Cuff, Konstantinos Stavroulakis, Efthymios Beropoulis, Angeliki Argyriou, Ian Loftus, Bilal Azhar, Sharvil Sheth, Marco Virgilio Usai, Asad Choudhry, Kira Nicole, Emily Boyle, Doireann Joyce, Mohammed Hassan Abdelaty Hassan, Alberto Saltiel, Gert Frahm-Jensen, George Antoniou, Muhammed Elhadi, Ali Kimyaghalam, Rafael Malgor, Leigh Ann O'Banion, Diego Telve, Andrej Isaak, Jürg Schmidli, Kevin McKevitt, Tam Siddiqui, Giuseppe Asciutto, Nikolaos Floros, George Papadopoulos, Alexandros Kafetzakis, Stylianos G. Koutsias, Petroula Nana, Athanasios Giannoukas, Stavros Kakkos, Konstantinos G. Moulakakis, Natasha Shafique, Arkadiusz Jawien, Matthew Popplewell, Chris Imray, Kumar Abayasekara, Timothy Rowlands, Ganesh Kuhan, Sriram Rajagopalan, Anthony Jaipersad, Uzma Sadia, Isaac Kobe, Devender Mittapalli, Ibrahim Enemosah, Christian-Alexander Behrendt, Adam Beck, Muayyad Almudhafer, Stefano Ancetti, Donald Jacobs, Priya Jayakumar, Fatemeh Malekpour, Sherene Shalhub, Boboyor Keldiyorov, Meryl Simon, Manar Khashram, Nicole Rich, Amanda Shepherd, Lewis Meecham, and Daniel Doherty

Subjects
AAA, COVID-19, PAD, Survey, Vascular surgery, Diseases of the circulatory (Cardiovascular) system, RC666-701, Surgery, RD1-811
Abstract

Objective: To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. Methods: An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March – May 2020, “period 1”), and then again between May and June (“period 2”) and June and July 2020 (“period 3”). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume. Results: The impact of the pandemic continued to be felt well after countries’ first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence. Conclusion: Centres reported a broad return of services approaching pre-pandemic “normal” by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries.

Published
2022
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