Effect of COVID-19 Pandemic on Mechanical Thrombectomy for Acute Ischemic Stroke Treatment in United States

Stroke due to atherosclerosis. Illustration of an arterial blockage (expanded view at upper right) causing a stroke (cerebrovascular accident, CVA). This stroke is due to a build-up of the plaque that forms in atherosclerosis. This blockage causes an interruption (occlusion) of the oxygenated blood supply. This will cause a stroke, where the brain is damaged due to hypoxia (lack of oxygen). The grey area at upper right shows the area of the brain affected by lack of oxygen. This type of stroke is known as an atherosclerotic stroke. Common causes are high blood pressure and arterial disease.
In some US States, a reduction was seen in the number of mechanical thrombectomy procedures performed for ischemic stroke in April 2020.

Mechanical thrombectomy procedures decreased in some US states in April 2020 which may reflect delays in specialized care access, decrease in stroke occurrence due to social distancing, and reluctance of patients with acute ischemic stroke to travel to the hospital during the coronavirus disease 2019 (COVID-19) pandemic. Findings were published in the Journal of Stroke.

This retrospective study relied on national utilization data of a stent retriever that represented mechanical thrombectomy procedures per month in each state from January 1, 2019, to April 30, 2020. Researchers across the United States analyzed the data and calculated the median number of such procedures performed each month prior to the pandemic based on data recorded between March 1, 2019 and February 29, 2020. A total of 25 states were excluded from the analysis.

The number of procedures performed in March 2020 was significantly lower in 7 states and higher in 6 states compared with the median number of procedures performed per month in the 12 months prior to the COVID-19 pandemic. The number of procedures was not significantly different in 11 states. In contrast, the number of mechanical thrombectomy procedures performed in April 2020 was lower in 11, higher in 3, and not significantly different in 10 states compared with the median number per month in the 12-month period before the pandemic.

New York state had a significant reduction in the number of mechanical thrombectomy procedures performed in March 2020 but not in April 2020 (47 vs 52, respectively). In the 12 months prior to the pandemic, the median monthly number of procedures performed in New York was 58.5. No relationship was observed between the total number of COVID-19 cases for each state and the change in the number of procedures performed.

Limitations of this study included its retrospective nature as well as the exclusion of 25 US states, which may have affected results.

Reflecting on this study, the researchers noted that their findings were largely representative “of [the] early part of the COVID-19 pandemic and additional changes may be seen as the pandemic continues to evolve.”


Qureshi A, Siddiq F, French B, et al. Effect of COVID-19 pandemic on mechanical thrombectomy for acute ischemic stroke treatment in United States. J Stroke Cerebrovasc Dis. Published online July 7, 2020. doi:10.1016/j.jstrokecerebrovasdis.2020.105140.