Abstract P18: Report on the Treatment Process and Impact of Mechanical Thrombectomy Before and After Coronavirus Disease in a Newly Opened Hospital of South Korea

Abstract

Introduction: The difficulty neurointernvetionists face in keeping “Time is brain” in the middle of the COVID-19 pandemic are inevitable. Our health system began shutting down entire hospital for two weeks after a transport agent was diagnosed with COVID-19. It took an additional two weeks to establish the process of emergency treatment. We intend to introduce our protocols and report on their progress so far. Post-COVID-19 Protocol (Figure 1) Methods: A total of 52 patients underwent mechanical thrombectomy at Eunpyeong St. Mary’s Hospital before the Covid-19 outbreak. For 18 patients who underwent mechanical thrombectomy through a new process after COVID-19, door-to-image time, door-to-puncture time, and TICI grade were compared. Results: For the treatment of all patients, portable chest x-ray imaging was performed, but the door-to-initial-brain-image time (min) was 15.5 vs. 15 (before COVID-19 vs. after COVID-19) (p=0.265). Door-to-needle-time (min) showed a delay of 9 minutes, from 144.5 to 153.5, but it was not statistically significant (p=0.299). Up to 95.2% of patients before COVID-19 achieved TICI grade 2b or higher, and 100% of patients after COVID-19 have achieved TICI grade 2b or 3. (Table 1) Conclusions: Overall, there was a slight increase in the door-to-needle time, but clear protocols and guidelines for management and collaboration with the clinical workforce have been able to reduce delays and ensure timely and adequate management. When referring to the protocol implemented while preparing for infectious diseases, it will be a reference not only for COVID-19, but also for other diseases that may occur in the future.