COVID-19 impact on vascular surgery practice: experience from an Italian university regional hub center for vascular pathology

Boschetti, Gian Antonio; Gregorio, Sara Di; Vera, Jorge Miguel Mena; Pane, Bianca; Spinella, Giovanni; Palombo, Domenico; Pratesi, Giovanni

Objectives: The aim of the study is to evaluate the impact of COVID-19 pandemic on vascular surgery practice in a regional hub center for complex vascular disease. Methods: This is an observational single-center study in which we collected clinical and surgical data during (P1) and after (P2) the COVID-19 outbreak and the lockdown measures implemented in Northern Italy. We compared those data with the two-month period before the pandemic (P0). Results: Compared to P0, ambulatory activities were severely reduced during P1 and limited to hospitalized patients and outpatients with urgent criteria. We performed 61 operations (18 urgent and 43 elective), with a decrease in both aortic (-17.8%), cerebrovascular (-53.3%) and peripheral artery (-42.6%) disease treatments. We also observed a greater drop in open procedures (-53.2%) than in endovascular ones (-22%). All the elective patients were treated for not-deferrable conditions and they were COVID-19 negative at the ward admission screening; despite this one of them developed COVID19 during the hospital stay. Four COVID-19 positive patients were treated in urgent setting for acute limb ischemia. Throughout P2 we gradually rescheduled elective ambulatory (+155.5%) and surgical (+18%) activities, whilst remaining substantially lower than during P0 (respectively -45.6% and -25.7%). Conclusions: Despite COVID-19 pandemic, our experience shows that with careful patient's selection, dedicated pre-hospitalization protocol and proper use of personal protective equipment it is possible to guarantee continuity of care.