1Yousef Yousef, 1Hiba Abdalla, 1Hala Al-Khaffaji, 1Delphine Qudreq, 1Ganesh Alluvada, 1Alison Edwards, 1Séan Matheiken, 1Davis Thomas, 1Maher Hamish

1Northampton General Hospital, Northampton, United Kingdom

Background:

Multiple bodies issued specialty advice during the UK’s first Covid-19 pandemic wave. We reviewed available guidance and produced a Covid-19-proofed pathway for local endovascular service provision, prior to availability of widespread testing.

Material(s) and Method(s):

1.         Formulation of local treatment policy [Table 1].

2.         Implementation of operational changes.

3.         Overview of clinical outcomes.

4.         Effectiveness of Covid-19 safety measures

Result(s):

1.         Triage outcomes are shown in Table 1, column 6. 

2.         Implementation:

  a.       All non-essential IR suite visits redirected to phone/email.

  b.       Temperature screening at entrance.

  c.       All out-patients as Day-case.

  d.       In-patient cases ‘last on list’.

  e.       Face masks at all times by all individuals.

  f.        PHE guidance-for the respective week- and local IPC policy followed.

  g.       Staff numbers precluded staggered or segregated working rotas.

3.         185 procedures were performed for 146 patients with < 2% major complications and no immediate perioperative mortality or limb loss. Fig 1

4.         26 procedure for Fistuloplaties were performed.

5.         Mortality < 2% within 30 days:

a.         One patient tested COVID-19 +ve and deceased within 2 weeks while inpatient with uncertain source of infection.

b.         One patient tested COVID-19 +ve and deceased within 26 days while inpatient with uncertain source of infection.

c.         . One patient deceased within 27days while inpatient with no COVID-19 test.

6.         No known outpatients and no involved staff tested Covid-19 positive within a fortnight of IR encounters.

Conclusion(s):

Our practice embodied consensus across four major guidance documents. Most advice (BSIR, VS, NHS) was generic and not condition specific. All specialty specific guidance omitted haemodialysis access. Our Covid-19 operational policy produced safe clinical outcomes.