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

Open AccessPublished:October 19, 2022DOI:https://doi.org/10.1016/j.ejvsvf.2022.10.002
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      Highlights

      • By the end of this survey (July 2020) a large proportion of centres had still not returned to normal levels of practice, even after infection rates dropped.
      • Aneurysm screening had not returned to normal in 21.7% of centres.
      • Fifty-three per cent of centres had returned to their normal aneurysm threshold for surgery.
      • Forty-nine per cent believe their management of lower limb ischaemia continued to be negatively affected.
      • Most responding centres now use “green” pathways to allow patients to undergo elective surgery safely.
      • At least one negative swab and 14 days of isolation were the most common strategies for permitting safe, elective surgery to recommence.
      • Large backlogs of cases for aortic aneurysm, lower limb open and endovascular revascularisation, and varicose vein surgery were reported.
      • Vascular surgeons will continue to face competition for resources with other specialties facing similar problems.

      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”). Each period was of a similar length of time. 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 prepandemic “normal” by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries.

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