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    Letter To The Editor: Iliac Arteries and Peripheral Artery Disease

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    Aji Prasetyo Utomo
    The document discusses preparations needed by a vascular surgery department for increased procedures after the end of the COVID-19 outbreak. It outlines several key areas: 1) evaluating aortic aneurysm cases for outpatient vs. inpatient treatment and prioritizing based on rupture risk; 2) scheduling ultrasound and angiogram exams that may be needed after the lockdown lifts; 3) preparing operating rooms and partnerships with other facilities to accommodate increased inpatient loads. The goal is to avoid vascular patients facing delays due to pandemic impacts and ensure continuity of necessary follow-up care.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Letter To The Editor: Iliac Arteries and Peripheral Artery Disease

    Uploaded by

    Aji Prasetyo Utomo
    30 views2 pages
    The document discusses preparations needed by a vascular surgery department for increased procedures after the end of the COVID-19 outbreak. It outlines several key areas: 1) evaluating aortic aneurysm cases for outpatient vs. inpatient treatment and prioritizing based on rupture risk; 2) scheduling ultrasound and angiogram exams that may be needed after the lockdown lifts; 3) preparing operating rooms and partnerships with other facilities to accommodate increased inpatient loads. The goal is to avoid vascular patients facing delays due to pandemic impacts and ensure continuity of necessary follow-up care.

    Original Title

    10.1016@j.avsg.2020.05.003(1)

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    The document discusses preparations needed by a vascular surgery department for increased procedures after the end of the COVID-19 outbreak. It outlines several key areas: 1) evaluating aortic aneurysm cases for outpatient vs. inpatient treatment and prioritizing based on rupture risk; 2) scheduling ultrasound and angiogram exams that may be needed after the lockdown lifts; 3) preparing operating rooms and partnerships with other facilities to accommodate increased inpatient loads. The goal is to avoid vascular patients facing delays due to pandemic impacts and ensure continuity of necessary follow-up care.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    30 views2 pages

    Letter To The Editor: Iliac Arteries and Peripheral Artery Disease

    Uploaded by

    Aji Prasetyo Utomo
    The document discusses preparations needed by a vascular surgery department for increased procedures after the end of the COVID-19 outbreak. It outlines several key areas: 1) evaluating aortic aneurysm cases for outpatient vs. inpatient treatment and prioritizing based on rupture risk; 2) scheduling ultrasound and angiogram exams that may be needed after the lockdown lifts; 3) preparing operating rooms and partnerships with other facilities to accommodate increased inpatient loads. The goal is to avoid vascular patients facing delays due to pandemic impacts and ensure continuity of necessary follow-up care.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Letter to the Editor

    Thinking Beyond the Box: Preparing ILIAC ARTERIES AND PERIPHERAL


    for the End of COVID-19 Outbreak in ARTERY DISEASE
    a Vascular Surgery Department
    Most of these patients can be treated as outpatient proced-
    On February 11, 2020, the World Health Organization ures, but care must be taken to identify the patient at risk
    declared the COVID-19 outbreak a pandemic, and since of complications. To plan interventions for peripheral ar-
    then, there has been a race against the clock to readjust tery disease patients, preoperatory examinations must be
    health care systems, to limit the spread, to find a treat- scheduled: Ultrasound examinations to evaluate the
    ment, or to develop a vaccine. permeability, venous cartography for bypasses, and angi-
    Hospitals have reorganized their activity to protect ography for below the knee pathologies.7 The necessity
    health care providers and have suspended elective cases. of balloon and stents will increase after the end of the
    Guidelines prioritizing vascular intervention during the outbreak and device companies may not be able to keep
    outbreak were elaborated by the scientific societies.1e3 up with orders.
    In a recent letter to editor, JJ Ng et al.4 showed that
    more than 90% of the vascular units had suspended or
    scaled down elective cases. HEMODIALYSIS ACCESSES
    Our department reduced the medical staff to the mini-
    Most hemodialysis access was not postponed but other pa-
    mum necessary to perform emergency interventions and
    tients will need follow-up and reinterventions and must
    all other procedures were canceled after careful revision.
    be considered in the future operating schedule.
    Here, we present our point of view regarding the prep-
    aration needed of a vascular unit for the end of COVID-19
    crisis. The extrapolation can help other units to find the
    CLINICAL TRIALS
    best way to organize and to foresee upcoming events.
    Most clinical trials were temporarily stopped and follow-
    up visits must be organized as soon as possible.

    AORTA
    GENERAL CONSIDERATION
    For EVAR and TEVAR, preparation is needed to re-
    evaluate the cases that are fit for outpatient procedures5 The use of operating theaters must be prepared in
    and re-evaluate the priority according to the risk of conjunction with other surgical units. For inpatient capac-
    rupture and the need of postprocedural intensive care. ity, a network of rehabilitation centers, home-care nurses,
    For FEVAR procedures and other custom-made prosthe- and telemedicine8 must be organized to ensure an optimal
    ses that are already manufactured, attention must be inflow and outflow of patients. Vascular patients must not
    paid to ensure that CT scans are not older than 6 months. become collateral damage of COVID-19; continuity of
    follow-up is key. The current crisis is unexpected and
    unique and we need to find solutions, be innovative,
    and hope for the best and prepare for the worst.
    CAROTID
    Calin Gheorghe Precup
    An ultrasound examination must be provided followed by Service de chirurgie vasculaire et endovasculaire
    a medical visit after the lockdown is lifted to confirm Etablissement Edouard Herriot
    permeability, mostly for tight lesions, to ensure usual Hospices Civils de Lyon
    follow-up and to prepare the further interventions if Lyon, France
    necessary.6
    Marine Bordet
    Patrick Lermusiaux
    Antoine Millon
    Service de chirurgie vasculaire et endovasculaire
    Ann Vasc Surg 2020; -: 1–2
    https://doi.org/10.1016/j.avsg.2020.05.003
    Etablissement Edouard Herriot
    Ó 2020 Elsevier Inc. All rights reserved. Hospices Civils de Lyon
    Published online: --,- Lyon, France

    1
    2 Letter to the Editor Annals of Vascular Surgery

    Universite Claude Bernard Lyon 1 https://vascularnews.com/vascular-society-issues-guidance


    Lyon, France -on-covid-19-and-vascular-surgery/. Accessed March 24, 2020.
    4. Ng JJ, Ho P, Dharmaraj RB, et al. The global impact of
    Nellie Della Schiava COVID-19 on vascular surgical services. J Vasc Surg 2020.
    Service de chirurgie vasculaire et endovasculaire 5. Wanhainen A, Verzini F, Van Herzeele I, et al. Editor’s Choice
    Etablissement Edouard Herriot - European Society for Vascular Surgery (ESVS) 2019 clinical
    Hospices Civils de Lyon practice guidelines on the management of abdominal aorto-
    Lyon, France iliac artery aneurysms. Eur J Vasc Endovasc Surg 2019;57:
    E-mail: calin-gheorghe.precup@chu-lyon.fr 8e93.
    6. Naylor AR, Ricco JB, de Borst GJ, et al. Management of
    atherosclerotic carotid and vertebral artery disease: 2017
    REFERENCES clinical practice guidelines of the European Society for
    Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg
    1. Zhu W, Wang Y, Xiao K, et al. Establishing and managing a
    2018;55:3e81.
    temporary coronavirus disease 2019 specialty hospital in
    7. Conte MS, Bradbury AW, Kolh P, et al. Global vascular
    Wuhan, China. Anesthesiology 2020;132:1339e45.
    guidelines on the management of chronic limb-
    2. Ueda M, Martins R, Hendrie PC, et al. Managing cancer care
    threatening ischemia. Eur J Vasc Endovasc Surg 2019;58:
    during the COVID-19 pandemic: agility and collaboration to-
    S1e109.
    ward a common goal. J Natl Compr Canc Netw 2020;20:1e4.
    8. Hollander JE, Carr BG. Virtually perfect? Telemedicine for
    3. Vascular Society issues guidance on COVID-19 and vascular sur-
    COVID-19. N Engl J Med 2020;382:1679e81.
    gery VASCULAR prioritisation.VascularNews. Available at,

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