ABSTRACT NUMBER: ESOC2026A1863 PERFORMANCE METRICS OF A NEUROVASCULAR MULTIDISCIPLINARY MEETING IN THE COVID-19 VS. PRE-COVID-19 AND POST-COVID-19 PERIODS

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