Background and Aims: The COVID-19 pandemic has had a significant impact on all areas of health and social care, and it was no different for patients with ischemic stroke (IS). The aim of this analysis was to determine the impact of the pandemic on the clinical outcomes of mechanical thrombectomy (MT) in patients with IS for large artery occlusion.
Methods: The study included patients who underwent MT between 2008 and 2022. Neurologic deficit was assessed using the National Institutes of Health Stroke Scale (NIHSS) and clinical outcome using the modified Rankin Scale (mRS). The presence of symptomatic intracerebral hemorrhage (SICH) was assessed according to the SITS-MOST criteria. The achieved recanalization was evaluated using the Thrombolysis in Cerebral Infarction scale (TICI). For the purposes of this study, the period before the Covid 19 pandemic was defined in terms of time (MT carried out until 31.3.2020) and the period after the pandemic from 1.4.2022. The data were evaluated for all patients and also individually for individual age groups.
Results: The data of 1350 patients who underwent MT for occlusion of a great artery were retrospectively evaluated. Before the start of the pandemic (893 patients, age 71.7±12.8, recanalization TICI≥2b 80.3%), good clinical success (mRS ≤2) was present in 48% and 30-day mortality was 31%. During the pandemic (327 patients, age 74.3±11.5, recanalization TICI≥2b 80.7%), clinical success decreased to 39.8% and mortality increased to 40.1%. After the pandemic (130 patients, age 75.1±12.6, recanalization TICI≥2b 80.8%), mortality dropped to 29.2%, but a good clinical result was still only achieved in 40%. We find a lower clinical success rate in all analyzed age categories.
Conclusion: The Covid 19 pandemic was reflected in clinical outcome in mechanical embolectomy patients of all age groups. According to our data, mortality has already returned to the pre-epidemic level, but the lower rate of clinical success of the procedure still persists.