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Supplementary Table 1 Survey Questionnaire Domain Name Question Stem Answer Choices Demographics

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Supplementary Table 1 Survey Questionnaire

Domain Name Question Stem Answer Choices

Demographics

Please specify your occupation. Anesthesiologist Intervention radiologist Stroke Neurologist Neurosurgeon Emergency Physician Where is your centre/organization/society located?

Place an "X" beside the option applying to you.

Africa - state name of your city and country Asia - state name of your city and country Oceania - state name of your city and country

North America – state name of your city and country:

South America - state name of your city and country Other - state name of your city and country

Prefer not to say How many confirmed cases of COVID-19 have been reported

in your city by May 28, 2020?

0-500 501-5000 5001-10000 10001 and more In view of COVID-19 pandemic, what is the current trend of

total number of stroke cases at your hospital?

Decreased substantially Decreased slightly Unchanged Increased slightly Increased substantially I do not know

In view of COVID-19 pandemic, what is the current trend of endovascular thrombectomy cases in your hospital?

Decreased substantially Decreased slightly Unchanged Increased slightly Increased substantially I do not know

Awareness

Is your center aware of implications of COVID-19 and endovascular management of stroke?

Not at all

Somewhat aware Fully aware Have you modified the protocol for managing such cases? No

Yes

(2)

Testing and Transportation

Does your center perform COVID-19 testing for stroke patients who undergo mechanical thrombectomy?

No

Yes, before the procedure Yes, after the procedure Do you see any changes in the transport time of stroke

patients from home to hospital during COVID-19 pandemic?

Decreased Unchanged Increased

Types of Stroke in

ER and Stroke team (COVID-19)

Do you have a dedicated stroke team at your center? No Yes

Who is responsible for patient’s monitoring during mechanical thrombectomy?

Nurse Technician

Anesthesiologist for all the cases

Anesthesiologist only for General Anesthetic Cases Monitoring is not required

Which types of stroke are being admitted at your center during the COVID-19 pandemic?

Ischemic Hemorrhagic Both equally I do not know

Safety And

Neurointervention environment

Do you wear full personal protective equipment PPE (based on your institutional/national guidelines) for EVT cases?

Full PPE not available

Full PPE for all cases irrespective of COVID-19 status and type of anesthetics

Full PPE only for known COVID-19 or symptomatic but irrespective of type of anesthetics

Full PPE only for known COVID-19 or symptomatic but general anesthesia (GA) cases or if converting to GA

Have all your team members practiced donning and doffing simulation or practice session in view of COVID-19

preparedness?

No Yes Optional Which type of operative room is available at your

neurointerventional suite?

Negative pressure Positive pressure

Both negative and positive rooms, separately Ambient

I do not know

Anesthetic choices,

Airway management options and sites

Where do you intubate the patient who require general anesthesia for mechanical thrombectomy during the COVID- 19 pandemic?

Emergency room

Special room outside of neurointerventional Inside the neurointerventional operating room ICU

What is the preferred method of intubation? Direct laryngoscopy Video laryngoscopy

Laryngeal Mask Airway (LMA) Other (please specify)

(3)

How has your anesthetic management in patients undergoing endovascular thrombectomy changed during the COVID-19 pandemic at your center?

No change Less cases of GA More cases of GA All cases in GA

All cases in Local Anesthetic What is the preferred method of oxygenation during sedation

(MAC) in these patients at your center?

Nasal prong Breathing mask

Breathing mask with special filter We do not use any

Other (please specify) Do you monitor end tidal carbon dioxide (ETCO2) routinely

during sedation in the setting of the COVID-19 pandemic?

No Yes

Perioperative

complications in relation to COVID- 19

In regards to stroke management, please check all of the following that have increased during the COVID-19 pandemic.

Door to CT time

Door to needle time (Thrombolytic Therapy)

Door to puncture time (Endovascular Thrombectomy) Time for anesthesia readiness

Time to recanalization I do not know

Do you observe perioperative complications in patients undergoing endovascular thrombectomy during the COVID- 19 pandemic? Multiple options can be selected.

Conversion of GA during procedure

Unmanageable movement due to coughing/sneezing Nausea/vomiting

Contamination Hypotension

Other (please specify) What is your set target for systolic BP during EVT under

GA?

No set target

Less than 140mmHg 140-180mmHg More than 180mmHg

Cleaning and

sterilization of equipments

Has your cleaning and sterilization process been modified for equipments and neuroradiological operating suites during COVID-19 pandemic at your center?

No Yes

I do not know How long do you wait for the next case, if the previous

patient is COVID-19 positive or suspect?

Less than 30 minutes 30-45 minutes 46 minutes to 1 hour More than 1 hour

Disposition

Where do you extubate the COVID-19 suspect or positive

patients after mechanical thrombectomy?

ICU

Intervention suite

Special room other than ICU Other (please specify) For local anesthesia or Monitored Anesthesia Case, do you

ask the patient to wear a surgical mask for the entire case?

No Yes

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