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Impact of the first COVID-19 pandemic peak and lockdown on the interventional management of carotid artery stenosis in France.
Crespy, Valentin; Benzenine, Eric; Mariet, Anne-Sophie; Baudry, Anna; Bernard, Chloe; Bejot, Yannick; Giroud, Maurice; Steinmetz, Eric; Quantin, Catherine.
  • Crespy V; Department of Cardiovascular and Thoracic Surgery, University Hospital of Dijon, Dijon, France.
  • Benzenine E; Biostatistics and Bioinformatics (DIM), University Hospital of Dijon, Dijon, France.
  • Mariet AS; Biostatistics and Bioinformatics (DIM), University Hospital of Dijon, Dijon, France; CIC1432, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, University Hospital of Dijon, Dijon, France.
  • Baudry A; Department of Cardiovascular and Thoracic Surgery, University Hospital of Dijon, Dijon, France.
  • Bernard C; Department of Cardiovascular and Thoracic Surgery, University Hospital of Dijon, Dijon, France.
  • Bejot Y; Neurology Department, University Hospital of Dijon, Dijon, France; Dijon Stroke Registry (Santé Publique France - Inserm) - EA 7460 (Pathophysiology and Epidemiology of Cerebro-CardioVascular Diseases), University of Burgundy, UFBC, Dijon, France.
  • Giroud M; Neurology Department, University Hospital of Dijon, Dijon, France; Dijon Stroke Registry (Santé Publique France - Inserm) - EA 7460 (Pathophysiology and Epidemiology of Cerebro-CardioVascular Diseases), University of Burgundy, UFBC, Dijon, France.
  • Steinmetz E; Department of Cardiovascular and Thoracic Surgery, University Hospital of Dijon, Dijon, France.
  • Quantin C; Biostatistics and Bioinformatics (DIM), University Hospital of Dijon, Dijon, France; CIC1432, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, University Hospital of Dijon, Dijon, France; Université Paris-Saclay, UVSQ, University of Paris-Sud, Inserm, High-Dimensional Biost
J Vasc Surg ; 75(5): 1670-1678.e2, 2022 05.
Article in English | MEDLINE | ID: covidwho-1568903
ABSTRACT

OBJECTIVE:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Endarterectomy, Carotid / Carotid Stenosis / Stroke / Endovascular Procedures / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: J Vasc Surg Journal subject: Vascular Diseases Year: 2022 Document Type: Article Affiliation country: J.jvs.2021.11.064

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Endarterectomy, Carotid / Carotid Stenosis / Stroke / Endovascular Procedures / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: J Vasc Surg Journal subject: Vascular Diseases Year: 2022 Document Type: Article Affiliation country: J.jvs.2021.11.064