Impact of COVID-19 on angioplasty service and outcome of patients treated for critical limb ischaemia

Abstract Background Peripheral artery disease (PAD) is a major challenge worldwide and endovascular revascularization an important component of treatment that affected by COVID-19 restrictions. Purpose Here, we evaluated the impact restriction on angioplasty service outcome patients undergoing lower limb angioplasty. Methods Consecutive revascularisation between August 2018-March 2021 in UK district general hospital were analysed retrospectively. Indications for all discussed agreed upon multi-disciplinary teams. We compared time from referral to angioplasty, patient procedural characteristics, technical success, peri-procedural complications, (wound healing, amputation, target lesion revascularization, death) treated 'before' after February 2020 (“during COVID-19”). Results One hundred nineteen (92% critical ischaemia [CLI]; 60% diabetes mellitus) 72 'during COVID-19' (96% CLI; 61% mellitus). While total monthly number did not change, outpatients as day cases increased (40% 72%) overnight stays social reasons decreased (16% 10%). Treatment hospitalized 44% 18%. The percentage at <14 days 39% 63% <5 47% 54%. Neither nor procedure wound healing (p(log Rank) = 0.451; median 168±25 days) amputation free survival 0.924; 368±30 CLI significantly. However, amputation-free was significantly worse <0.001; 155±20 vs with similar those survived 0.340; days). Of note, known causes death sepsis (32%), pneumonia (18%), COVID cardiac (16%) stroke (8%). Conclusions Adapting maintained safe effective while shortening waiting times. Very high mortality rates hospitalization indicated need be much earlier more aggressively avoid progression requiring hospitalization. FUNDunding Acknowledgement Type funding sources: None.