The Impact of the COVID-19 Pandemic on a Dedicated Vascular Emergency Clinic

Background: Vascular Emergency Clinics (VEC) improve patient outcomes in chronic limb -threatening ischemia (CLTI). They provide a "1 stop"open access policy, whereby "suspicion of CLTI"by a healthcare professional or patient leads to a direct review. We assessed the resil-ience of the outpatient VEC model to the first year of the coronavirus disease (COVID-19) pandemic.Methods: A retrospective review of a prospectively maintained database of all patients assessed in our VEC for lower limb pathologies between March 2020 and April 2021 was per-formed. This was cross-referenced to national and loco-regional Governmental COVID-19 data. Individuals with CLTI were further analysed to determine Peripheral Arterial Disease-Quality Improvement Framework compliance.Results: Seven hundred and ninety one patients attended for 1,084 assessments (Male n = 484, 61%; Age 72.5 & PLUSMN; standard deviation 12.2 years; White British n = 645, 81.7%). In total, 322 patients were diagnosed with CLTI (40.7%). A total of 188 individuals (58.6%) underwent a first revascularization strategy (Endovascular n = 128, 39.8%; Hybrid n = 41, 12.7%; Open sur-gery n = 19, 5.9%; Conservative n = 134, 41.6%). Major lower limb amputation rate was 10.9% (n = 35) and mortality rate was 25.8% (n = 83) at 12 months of follow-up. Median referral to assessment time was 3 days (interquartile range: 1-5). For the nonadmitted patient with CLTI, the median assessment to intervention was 8 days (interquartile range: 6-15) and median referral to intervention time of 11 days (11-18). Conclusions: The VEC model has demonstrated strong resilience to the COVID-19 pandemic with rapid treatment timelines maintained for patients with CLTI.