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1.
Cardiovasc Intervent Radiol ; 44(6): 871-876, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1173899

ABSTRACT

PURPOSE: Evaluation and registration of patient and staff doses are mandatory under the current European legislation, and the occupational dose limits recommended by the ICRP have been adopted by most of the countries in the world. METHODS: Relevant documents and guidelines published by international organisations and interventional radiology societies are referred. Any potential reduction of patient and staff doses should be compatible with the clinical outcomes of the procedures. RESULTS: The review summarises the most common protective measures and the needed quality control for them, the criteria to select the appropriate protection devices, and how to avoid unnecessary occupational radiation exposures. Moreover, the current and future advancements in personnel radiation protection using medical simulation with virtual and augmented reality, robotics, and artificial intelligence (AI) are commented. A section on the personnel radiation protection in the era of COVID-19 is introduced, showing the expanding role of the interventional radiology during the pandemic. CONCLUSION: The review is completed with a summary of the main factors to be considered in the selection of the appropriate radiation protection tools and practical advices to improve the protection of the staff.


Subject(s)
Occupational Exposure/prevention & control , Radiation Injuries/prevention & control , Radiation Protection , COVID-19/epidemiology , Europe/epidemiology , Humans , Pandemics , Radiation Dosage , Radiation Protection/methods , Radiology, Interventional/methods , SARS-CoV-2
2.
Curr Probl Diagn Radiol ; 50(3): 284-287, 2021.
Article in English | MEDLINE | ID: covidwho-1015060

ABSTRACT

The COVID-19 pandemic has challenged the capacity of interventional radiology departments worldwide to effectively treat COVID-19 and non-COVID-19 patients while preventing disease transmission among patients and healthcare workers. In this review, we describe the various data driven infection control measures implemented by the interventional radiology department of a large tertiary care center in the United States including the use and novel re-use of personal protective equipment, COVID-19 testing strategies, modifications in procedural workflows and the leveraging of telehealth visits. Herein, we provide effective triage, procedural, and management algorithms that may guide other interventional radiology departments during the ongoing COVID-19 pandemic and in future infectious disease outbreaks.


Subject(s)
COVID-19/prevention & control , Infection Control/methods , Radiology Department, Hospital , Radiology, Interventional/methods , Humans , Pandemics , Personal Protective Equipment , SARS-CoV-2 , Tertiary Care Centers , United States
3.
Cardiovasc Intervent Radiol ; 44(1): 134-140, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-910262

ABSTRACT

INTRODUCTION: The coronavirus disease 2019 (COVID-19) has created unprecedented challenges on the healthcare system. The aim of this multi-centre study was to measure the impact of COVID-19 on IR services in the UK. MATERIAL AND METHODS: Retrospective cross-sectional study of IR practice in six UK centres during the COVID-19 pandemic was carried out. All therapeutic IR procedures were identified using the respective hospital radiology information systems and COVID-19 status found on the hospital patient record systems. The total number of therapeutic IR procedures was recorded over two time periods, 25/03/2019-21/04/2019 (control group) and 30/03/2020-26/04/2020 (COVID-19 group). The data points collected were: procedure type, aerosol-generating nature, acute or elective case, modality used, in- or out-of-hours case and whether the procedure was done at the bedside (portable). RESULTS: A 31% decrease in overall number of IR procedures was observed during COVID-19 compared to the control group (1363 cases vs 942 cases); however, the acute work decreased by only 0.5%. An increase in out-of-hours work by 10% was observed. COVID-19 was suspected or laboratory proved in 9.9% of cases (n = 93), and 15% of total cases (n = 141) were classed as aerosol-generating procedures. A 66% rise in cholecystostomy was noted during COVID-19. Image-guided ablation, IVC filters, aortic stent grafting and visceral vascular stenting had the greatest % decreases in practice during COVID-19, with 91.7%, 83.3%, 80.8% and 80.2% decreases, respectively. CONCLUSION: During the global pandemic, IR has continued to provide emergency and elective treatment highlighting the adaptability of IR in supporting other specialties.


Subject(s)
COVID-19/prevention & control , Radiology, Interventional/methods , Radiology, Interventional/statistics & numerical data , Cross-Sectional Studies , Female , Humans , Male , Pandemics , Retrospective Studies , SARS-CoV-2 , United Kingdom
4.
J Cancer Res Ther ; 16(5): 974-978, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-809821

ABSTRACT

The pandemic of coronavirus disease 2019 (COVID-19) has become a major public health threat to the whole world. Although the control of COVID-19 has been in the forefront of interventional practice, most interventional radiologists (IRs) are not equipped adequately to cope with such a crisis. In this review, we share our experience from Chinese IRs' perspective, report on the acute measures instituted within interventional radiology (IR) units, and give recommendations to the prevention and control of COVID-19.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/prevention & control , Infection Control/standards , Pandemics/prevention & control , Personal Protective Equipment/standards , Pneumonia, Viral/prevention & control , Practice Patterns, Physicians'/standards , Radiology, Interventional/methods , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Humans , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Radiology, Interventional/instrumentation , SARS-CoV-2
5.
Neuroradiol J ; 33(5): 353-367, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-748861

ABSTRACT

The ongoing COVID-19 pandemic has forced every radiology set-up to evolve and formulate guidelines for day-to-day functioning. The sub-speciality of neuroradiology, both diagnostic and neuro-intervention, forms a very important part of any radiology or 'neuro-care' set-up. The present document is a consensus statement of the Indian Society of Neuroradiology, prepared after reviewing the available data and working experience. It scientifically tries to answer many questions faced by neuroradiologists everyday in practice. It encompasses simple things such as which patients need to be imaged, what precautions are essential, the work-flows, cleaning of radiology equipment, how to carry out neuro-interventions in COVID-suspect patients, and what procedures/tests to avoid, or their alternatives, to minimise the spread of COVID infection both to the patients and health care personnel. As radiology set-ups can be large, every sub-speciality may have certain precautions which will not be covered in general guidelines, and this document tries to answer those for neuroradiologists. Carefully evolved Standards of Operating Procedure (SOPs) and guidelines are the need of the hour to guide in providing uninterrupted and adequate services to the needy without compromising the safety of the specialised work force and facilities involved.


Subject(s)
Coronavirus Infections/prevention & control , Infection Control/methods , Neuroimaging/methods , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Radiology, Interventional/methods , Allied Health Personnel , Betacoronavirus , COVID-19 , Disinfection , Emergencies , Fumigation , Humans , India , Personal Protective Equipment , Personnel Staffing and Scheduling , Radiology/methods , SARS-CoV-2 , Societies, Medical , Ventilation
7.
J Vasc Interv Radiol ; 31(8): 1315-1319.e4, 2020 08.
Article in English | MEDLINE | ID: covidwho-634552

ABSTRACT

Telehealth has not previously been widely implemented as a result of regulatory and reimbursement concerns; however, in the current national emergency of the COVID-19 pandemic, the Centers for Medicare and Medicaid Services has relaxed many of its rules, allowing increased adoption of telehealth services, improving the safety and access of outpatient health care. A complete understanding of the regulatory requirements, technologic options, and billing processes of telehealth is required to initiate a successful clinic. A model is presented here based on a single institution's experience with implementing telehealth in the outpatient interventional radiology clinic.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Radiology, Interventional/methods , Telemedicine/methods , COVID-19 , Centers for Medicare and Medicaid Services, U.S. , Humans , SARS-CoV-2 , United States
8.
Eur Radiol ; 30(12): 6940-6949, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-618199

ABSTRACT

OBJECTIVES: To retrospectively analyze interventional radiology (IR) activity changes in the COVID-19 era and to describe how to safely and effectively reorganize IR activity. METHODS: All IR procedures performed between January 30 and April 8, 2020 (COVID-era group) and the same 2019 period (non-COVID-era group) were retrospectively included and compared. A sub-analysis for the lockdown period (LDP: 11 March-8 April) was also conducted. Demographic, hospitalization, clinical, and procedural data were obtained for both groups and statistically compared with univariable analysis. RESULTS: A total of 1496 procedures (non-COVID era, 825; COVID era, 671) performed in 1226 patients (64.9 ± 15.1 years, 618 women) were included. The number of procedures decreased by 18.6% between 2019 and 2020 (825 vs 671, p < .001), with a reduction by 48.2% in LDP (188 vs 363, p < .0001). In the LDP COVID era, bedside procedures were preferred (p = .013), with an increase in procedures from the intensive care unit compared with the emergency department and outpatients (p = .048), and an increased activity for oncological patients (p = .003). No incidents of cross-infection of non-infected from infected patients and no evidence of COVID-19 infection of healthcare workers in the IR service was registered. CONCLUSIONS: Coronavirus disease outbreak changed the interventional radiology activity with an overall reduction in the number of procedures. However, this study confirms that interventional radiology continuum of care can be safely performed also during the pandemic, following defined measures and protocols, taking care of all patients. KEY POINTS: • Coronavirus disease pandemic determined a reduction of interventional radiology activity as compared to the same period of the previous year. • Interventional radiology procedures for life-threatening conditions and non-deferrable oncologic treatments were prioritized as opposed to elective procedures. • Strict adoption of safe procedures allowed us to have until now no incidents of cross-infection of non-infected from infected patients and no evidence of COVID-19 infection of HCWs in the IR service.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnosis , Pandemics , Pneumonia, Viral/diagnosis , Radiography/methods , Tertiary Care Centers/statistics & numerical data , Aged , COVID-19 , Coronavirus Infections/epidemiology , Emergency Service, Hospital/statistics & numerical data , Female , Hospitalization/trends , Humans , Italy/epidemiology , Longitudinal Studies , Male , Middle Aged , Pneumonia, Viral/epidemiology , Radiology, Interventional/methods , Retrospective Studies , SARS-CoV-2
9.
Cardiovasc Intervent Radiol ; 43(8): 1208-1215, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-324500

ABSTRACT

COVID-19 (SARS-CoV-2 virus) pandemic was recently declared by the WHO as a global health emergency. A group of interventional radiology senior experts developed a consensus document for infection control and management of patients with COVID-19 in interventional radiology (IR) departments. This consensus statement has been brought together at short notice with the help of different protocols developed by governmental entities and scientific societies to be adapted to the current reality and needs of IR Departments. Recommendations are the specific strategies to follow in IR departments, preventive measures and regulations, step by step for donning and doffing personal protective equipment, specific IR procedures which can not be delayed, and aerosol-generating procedures in IR with COVID-19 patients. It is advisable with this document to be adapted to local workplace policies.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Infection Control/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Radiology, Interventional/methods , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Disease Outbreaks , Humans , Personal Protective Equipment , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Radiology, Interventional/instrumentation , SARS-CoV-2
10.
Can Assoc Radiol J ; 71(4): 514-517, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-209502

ABSTRACT

The current coronavirus disease 2019 (COVID-19) pandemic is creating significant challenges to the Canadian health system, including the practice of interventional radiology (IR). Interventional radiology will continue to play an important role in patient care, during this crisis. This document serves to guide interventional and general radiologists in safely performing IR procedures on patients with suspected or confirmed COVID-19, using the best evidence, guidelines and expert recommendations available. These strategies include reviewing procedural indications, development of tactics to minimize cross contamination prior to the intervention, appropriate usage of personal protection equipment according to the type of procedure (along with defining aerosol-generating procedures in IR), along with developing the appropriate work environment during the COVID-19 pandemic. By adopting the policies described, hospitals will protect the interventional radiologists, medical radiation technologists, nurses, ancillary staff, along with patients who benefit from their care.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/prevention & control , Radiology, Interventional/methods , COVID-19 , Canada , Humans , Lung/diagnostic imaging , Radiologists , SARS-CoV-2
11.
Cardiovasc Intervent Radiol ; 43(6): 827-836, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-125396

ABSTRACT

With astonishing speed, COVID-19 has become a global pandemic. As it is uncertain when the pandemic will be controlled, it is crucial for procedurists of all stripes to be familiar and confident in performing procedures for COVID-19 patients to prevent intra-hospital infection. In this article, we will detail our approach on how to perform interventional procedures for COVID-19 patients at the bedside in the isolation room and with the patient transferred to the interventional radiology centre. These workflows have been developed in conjunction with multiple other stakeholders within our hospital, drawing from valuable lessons we have learnt from the SARS outbreak of 2003.


Subject(s)
Coronavirus Infections , Pandemics , Pneumonia, Viral , Radiology, Interventional/methods , Betacoronavirus , COVID-19 , Disease Transmission, Infectious/prevention & control , Humans , SARS-CoV-2
12.
Swiss Med Wkly ; 150: w20261, 2020 04 20.
Article in English | MEDLINE | ID: covidwho-116873

ABSTRACT

Given the importance of continuum in providing services and exigence of protecting health care professionals during this period, the Swiss Society of Vascular and Interventional Radiology (SSVIR) is releasing guidance for interventional radiologists as preparedness to manage COVID-19 patients, the workflow of non-COVID-19 patients and optimize interactions with other healthcare professionals.


Subject(s)
Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Radiology, Interventional/methods , Radiology, Interventional/standards , Betacoronavirus/isolation & purification , COVID-19 , Humans , SARS-CoV-2 , Workflow
13.
J Vasc Interv Radiol ; 31(6): 869-875, 2020 06.
Article in English | MEDLINE | ID: covidwho-42072

ABSTRACT

This paper describes country-wide special measures undertaken for interventional radiology staff during the current coronavirus disease 2019 (COVID-19) pandemic. Although each interventional radiology service around the world faces unique challenges, the principles outlined in this article will be useful when designing or strengthening individual practices and integrating them within wider hospital and national measures. Moving beyond the current outbreak, these measures will be useful for any future infectious diseases which are likely to arise.


Subject(s)
Coronavirus Infections/complications , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/complications , Pneumonia, Viral/prevention & control , Radiology, Interventional/methods , COVID-19 , Humans , Singapore
14.
J Vasc Interv Radiol ; 31(6): 876-881, 2020 06.
Article in English | MEDLINE | ID: covidwho-42071

ABSTRACT

The outbreak of coronavirus disease 2019 (COVID-19) in late December 2019 in Wuhan, China, has been characterized as a "pandemic" by the World Health Organization and has resulted in 81,603 confirmed cases in China, among the 334,981 cases confirmed in 189 countries as of 09:00 am, March 24, 2020 (China central standard time). During the past 3 months, hundreds of thousands of Chinese health care workers, including interventional radiologists (IRs), have been fighting this battle against the horrifying COVID-19 disease. As IRs, what should we know and what can we do when facing this challenge? This paper shares the experience we have gone through.


Subject(s)
Coronavirus Infections/complications , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/complications , Pneumonia, Viral/prevention & control , Radiology, Interventional/methods , COVID-19 , Humans , Radiologists
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