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March 28, 2020

SNIS Provides Recommendations for Emergent Neurointerventional Patients in the COVID-19 Setting

March 28, 2020—The Society of NeuroInterventional Surgery (SNIS) announced it has developed a set of care recommendations for neurointerventional physicians that cover management of stroke thrombectomy, with an emphasis on safety measures for health care providers in the context of the COVID-19 pandemic.

The recommendations are available on the SNIS website, here.

According to the SNIS recommendations, acute ischemic stroke (AIS) patients are a high-risk patient cohort, and patients with a history of AIS and/or its risk factors are particularly at risk for the severe form of COVID-19. Additionally, there is early evidence that SARS-CoV-2 can cause neurologic signs and that it has been reported in the brains of both patients and animal models.

The document advises on the criteria for mechanical thrombectomy and provides additional postthrombectomy principles in the COVID-19 setting, with guidance for treating patients who are COVID-positive, COVID-negative, or COVID-undocumented.

The SNIS document states, “The presence of COVID-19 as a public health issue should not alter the inclusion and exclusion criteria for mechanical thrombectomy. We recommend that providers use currently available guidelines and recommendations based on multiple randomized trials for identification and management of large vessel occlusion whenever possible. Because of the significant proven benefit of thrombectomy for patients with emergent large vessel occlusions, denial of this treatment likely creates a greater drain on health care resources.”

As the COVID-19 pandemic continues to unfold, SNIS will consider revisiting these recommendations if needed to match up-to-date information. Any such revisions will be provided as updates on the SNIS web page, advised the society.

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