Abstract Background and aims International guidelines support discussion at a Neurovascular Multidisciplinary Meeting (NVMDM) to reach evidence-based decisions regarding revascularisation and/or optimal medical treatment of patients with atherosclerotic carotid artery stenosis. Data are limited on the impact the COVID-19 pandemic on performance metrics of a NVMDM. Methods This prospective audit/quality improvement project compared proportions of extracranial carotid stenosis patients in whom ‘consensus management decisions’ were reached at weekly Regional NVMDM during the ‘COVID-19’ main-pandemic (March 2020-September 2022) vs. ‘pre-COVID’ (September 2017-Febuary 2020) and ‘post-COVID’ (October 2022–February 2025) periods. We analysed adherence to NVMDM decisions in asymptomatic carotid stenosis ACS, symptomatic carotid stenosis SCS and ‘indeterminate symptomatic status stenosis ISS’ patients, including intervals between symptom onset to NVMDM discussion +/- intervention, and post-NVMDM outcomes. Results Consensus decisions regarding management were reached in 97.9% (93/95) of COVID vs. 96.3% (104/108) of pre-COVID, and 100% (64/64) of post-COVID patients (P≥0.69). Adherence to NVMDM recommendations remained high during COVID (90.4%), pre-COVID (96.2%) and post-COVID (93.2%) periods, respectively (P≥0.10). Median intervals from index symptoms to revascularisation in 50-99% SCS patients were similar between the COVID (10.5d), pre-COVID (12.5d) and post-COVID (12.5d) periods (P≥0.24). Median intervals from NVMDM discussion to revascularisation were 3.5d (IQR: 1-7d) during the COVID period vs. 5.5d (IQR: 1-7d) during the pre-COVID period (P=0.58); vs. 3.5d (IQR: 1-7) during the post-COVID period (P=0.19). Conclusions One can maintain a high frequency of inter-speciality consensus re evidence-based management, adherence to treatment advice and guidelines regarding time-to-revascularisation of carotid stenosis patients throughout/after a pandemic. Conflict of interest No conflict of interest. Prof. McCabe's research work is supported by grant funding from several charities and organisations, including the Meath Foundation, Ireland; The Adelaide Health Foundation, Ireland; an Enterprise Ireland Innovation Partnership Programme grant with Acquis BI Technology, Ltd.; the VNRF, Ireland; and in-kind contributions from Werfen, Spain; Sysmex Ireland-UK; Sinnowa, China; Genomadix Inc., Canada and Acquis BI Technology Ltd. Note: The late Prof. Sean Tierney was instrumental to the successful conduct of our Neurovascular Multidisciplinary Meeting, and in collection and interpretation of data. The remaining members of the TUH/AMNCH Neurovascular Multidisciplinary Team who also qualify for authorship are: McCarthy AJ (1, 2, 3), Hayden D (2, 5), Coveney S (2, 5), Murphy SM (1, 3), O’Connell K (1, 2, 3), Bogdanova-Mihaylova P (1, 2, 3), Healy DA (4), Noor A (4), Walsh J (7), Ward P (7), McGrath R (7), Martin M (8), O Driscoll A (8), Smith DR (1, 3, 6), Naydonova I (1, 2, 3) and Mavridis T (1, 2): (7) Department of Radiology, Tallaght University Hospital (TUH) / The Adelaide and Meath Hospital, Dublin, incorporating the National Children’s Hospital (AMNCH) / Dublin, Ireland; (8) Naas General Hospital, Co. Kildare, Ireland
Murtagh et al. (Fri,) studied this question.