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