Impact of the first COVID-19 pandemic peak and lockdown on the interventional management of carotid artery stenosis in France.
COVID-19
/ epidemiology
Carotid Stenosis
/ diagnostic imaging
Communicable Disease Control
Constriction, Pathologic
/ complications
Endarterectomy, Carotid
/ adverse effects
Endovascular Procedures
/ methods
Humans
Pandemics
Retrospective Studies
Risk Assessment
Risk Factors
Stents
Stroke
Time Factors
Treatment Outcome
Carotid artery stenosis
Carotid artery stenting
Carotid endarterectomy
Coronavirus disease 2019
Lockdown
Pandemic peak
Journal
Journal of vascular surgery
ISSN: 1097-6809
Titre abrégé: J Vasc Surg
Pays: United States
ID NLM: 8407742
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
received:
10
06
2021
accepted:
12
11
2021
pubmed:
19
12
2021
medline:
27
4
2022
entrez:
18
12
2021
Statut:
ppublish
Résumé
The aim of this study was to evaluate the impact of the COVID-19 pandemic on the trends of carotid revascularization (endarterectomy [CEA], transfemoral carotid artery stenting [TFCAS]) for symptomatic and asymptomatic carotid stenosis before, during, and after the end of the first lockdown in 2020 in France. Nationwide data were provided by the French National Hospital Discharge database (Programme de Médicalisation des Systèmes d'Information). We retrospectively analyzed patients admitted for CEA or TFCAS in all French public and private hospitals during a 9-month period (January-September) in 2017, 2018, 2019, and 2020. Procedures were identified using the French Common Classification of Medical Procedures. Stenoses were considered symptomatic in the presence of stroke and/or transient ischemic attack codes (according to the International Classification of Diseases-Tenth Revision) during the stay, and asymptomatic in the absence of these codes. Hospitalization rates in 2020 were compared with the rates in the same period in the 3 previous years. Between January and September 2020, 12,546 patients were hospitalized for carotid artery surgery (CEA and TFCAS) in France. Compared with the 3 previous years, there was a decrease in hospitalization rates for asymptomatic (-68.9%) and symptomatic (-12.6%) CEA procedures in April, starting at the pandemic peak concomitant with the first national lockdown. This decrease was significant for asymptomatic CEA (P < .001). After the lockdown, while CEA for asymptomatic stenosis returned to usual activity, CEA for symptomatic stenosis presented a significant rebound, up 18.52% in August compared with previous years. Lockdown also had consequences on TFCAS procedures, with fewer interventions for both asymptomatic (-60.53%) and symptomatic stenosis (-16.67%) in April. This study demonstrates a severe decrease for all interventions during the first peak of the COVID-19 pandemic in France. However, the trends in the postlockdown period were different for the various procedures. These data can be used to anticipate future decisions and organization for cardiovascular care.
Identifiants
pubmed: 34921965
pii: S0741-5214(21)02600-8
doi: 10.1016/j.jvs.2021.11.064
pmc: PMC8684845
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1670-1678.e2Informations de copyright
Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.
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