Experience in Mechanical Thrombectomy for Acute Stroke Treatment during Pandemic: A Single Center Report

Abstract

Objective: The COVID-19 disease affected most hospitals with its rapid spread and increased number of severe cases. Thus, delays in acute ischemic stroke care and a decline in hospitalization and interventions, such as endovascular thrombectomy, have been reported. With the present study, we aimed to evaluate baseline patient characteristics and determine the impact of pandemics on MT-related outcomes. Materials and methods: The hospital database was scanned for the patients diagnosed with acute ischemic stroke and treated via mechanical thrombectomy. The patients enrolled in the study were evaluated for their demographic features, infarct characteristics, clinical neurological scores (NIHSS and mRS) on admission and discharge, the TICI results, and the clinical course of the disease. Results: 250 patients were diagnosed with acute ischemic stroke during the Sep.2020-Oct.2021 period. Of the 158 patients were eligible for mechanical thrombectomy. Among the patients who underwent MT, 8 (5.06%) were diagnosed with COVID-19. While the median NIHSS score on admission was 12 (±4.16), the final post-procedural NIHSS score on discharge was 6 (±5.00). The most commonly occluded artery was MCA in 128 (81.01%) patients. While 76 (%48.10) of the patients resulted in procedural success with a TICI 3 score, a post-procedural intracranial hemorrhage was observed in 35 (22%) patients. A total of 90 (%56.96) patients were discharged with a good neurological outcome, while 32 (%20.25) had a lethal result. The outcome data of some patients (32 (%20.25) in particular) could not be obtained. Those patients needed to be referred to another ICU after the MT procedure because of the present hospital's lack of ICU beds. Conclusion: The rate of COVID-19 infection was low among stroke patients who underwent MT. Moreover, all patients who underwent intervention due to a lack of intensive care beds could not be followed up in our hospital and had to be referred to an external center.