View More View Less
  • 1 Heart and Vascular Center, Semmelweis University, Budapest, Hungary
  • | 2 Hungarian Vascular Radiology Research Group, Budapest, Hungary
  • | 3 Medical Imaging Center, Semmelweis University, Budapest, Hungary
Open access

Abstract

Aim

To assess the impact of the COVID-19 outbreak on trends in hospital admissions and number of diagnostic and therapeutic procedures in the largest tertiary vascular center in Hungary.

Patients and Methods

A retrospective analysis was carried out. The first wave of the COVID-19 pandemic occurred approximately from March 15 until June 1 in Hungary. We have compared the same period of 2020 to 2019. Electronic medical records were reviewed for the clinical status of the patients and treatment-related information.

Results

The total number of diagnostic angiographies and therapeutic interventions in 2020 (N = 233) decreased significantly (P = 0.046) compared to 2019 (N = 373). The ratio of Fontaine stage I–II cases to Fontaine stage III–IV cases for both diagnostic angiographies and therapeutic interventions was significantly lower (OR, 2.11; 95% CI, 1.26–3.59; P = 0.007 and OR, 3.22; 95% CI, 1.67–6.52; P < 0.001) in 2020 (0.36 and 0.27) than in 2019 (0.77 and 0.89). There was also a negative but not significant change in the number of supra-aortic (including internal carotid artery stenting) (P = 0.128) and other vascular therapeutic interventions (superior vena caval stenting, hemodialysis access percutaneous transluminal angioplasty [PTA], visceral artery/vein PTA/stenting, embolization) (P = 0.452) in 2020 (N = 16 and N = 21) compared to 2019 (N = 39 and N = 37).

Conclusion

The first wave of the COVID-19 pandemic had a negative effect on the total number of endovascular procedures in the largest tertiary vascular center in Hungary.

Abstract

Aim

To assess the impact of the COVID-19 outbreak on trends in hospital admissions and number of diagnostic and therapeutic procedures in the largest tertiary vascular center in Hungary.

Patients and Methods

A retrospective analysis was carried out. The first wave of the COVID-19 pandemic occurred approximately from March 15 until June 1 in Hungary. We have compared the same period of 2020 to 2019. Electronic medical records were reviewed for the clinical status of the patients and treatment-related information.

Results

The total number of diagnostic angiographies and therapeutic interventions in 2020 (N = 233) decreased significantly (P = 0.046) compared to 2019 (N = 373). The ratio of Fontaine stage I–II cases to Fontaine stage III–IV cases for both diagnostic angiographies and therapeutic interventions was significantly lower (OR, 2.11; 95% CI, 1.26–3.59; P = 0.007 and OR, 3.22; 95% CI, 1.67–6.52; P < 0.001) in 2020 (0.36 and 0.27) than in 2019 (0.77 and 0.89). There was also a negative but not significant change in the number of supra-aortic (including internal carotid artery stenting) (P = 0.128) and other vascular therapeutic interventions (superior vena caval stenting, hemodialysis access percutaneous transluminal angioplasty [PTA], visceral artery/vein PTA/stenting, embolization) (P = 0.452) in 2020 (N = 16 and N = 21) compared to 2019 (N = 39 and N = 37).

Conclusion

The first wave of the COVID-19 pandemic had a negative effect on the total number of endovascular procedures in the largest tertiary vascular center in Hungary.

Introduction

The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact on the healthcare system worldwide [1]. Prevention of hospital-acquired infections is a critical and necessary task, especially during a pandemic. Compared to open vascular surgery procedures, the duration of hospitalization for endovascular interventions is generally shorter, resulting in reduced exposure to nosocomial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission [2]. However, like other specialties, interventional radiology had to adapt to the new situation rapidly [2].

There are concerns that the COVID-19 pandemic negatively affects the quality of care for patients with acute vascular disorders [3]. For example, while assessment of patients with intermittent claudication (Fontaine stage II) may be delayed for 2–3 months, Fontaine stages III and IV are urgent medical conditions [4]. We aimed to investigate the influence of the COVID-19 outbreak on trends in hospital admissions and number of diagnostic and therapeutic interventional procedures in the largest tertiary vascular center in Hungary.

Patients and methods

A retrospective analysis from a single institution of all diagnostic and therapeutic vascular interventional procedures was carried out. The first wave of the COVID-19 pandemic occurred approximately from March 15 until June 1 in Hungary. We have compared the same period (between March 15 and June 1) of 2020 to 2019.

Institutional Review Board approval was granted (Approval No: 177/2020). Due to the retrospective nature of this study, patient informed consent for analysis of data was not obtained. Electronic medical records were reviewed for the clinical status of the patients (Fontaine stages) [4] and procedural information.

Statistical analysis

We used the Wilcoxon signed-rank test to identify the types of vascular interventional procedures of which significantly less were performed in 2020 than in 2019. We used the Chi-square test to compare distributions of the vascular interventional procedures between the 2020 and the 2019 time frames. Alternatively, when the number of procedures in a category was less than five, the Fisher’s exact test was used. We adjusted the level of significance (P) in case of multiple comparisons with the Bonferroni correction. We calculated the odds ratio (OR) from a two-by-two contingency table to determine the size of the effect of the time frame on the probability of a vascular procedure. The OR was presented together with its 95% confidence interval (CI). Statistical calculations were completed with the R.3.5.2. software (www.r-project.org).

Results

In 2020, 233 vascular interventional procedures (diagnostic, N = 126; therapeutic, N = 107), while in 2019, 373 (diagnostic, N = 178; therapeutic, N = 195) were performed. The number of all vascular procedures (diagnostic angiographies and therapeutic interventions) was significantly lower (P = 0.046) in 2020 (N = 233) than in 2019 (N = 373).

Among the diagnostic angiographies, in 2020, 113 were lower extremity related (Fontaine stage I, N = 1; Fontaine stage II, N = 29; Fontaine stage III–IV, N = 83), while in 2019, 159 (Fontaine stage I, N = 3; Fontaine stage II, N = 66; Fontaine stage III–IV, N = 90). The number of lower extremity diagnostic angiographies carried out in 2020 was non-significantly lower (OR, 1.27; 95% CI, 0.91–1.76; P = 0.184) than that in 2019. The ratio of Fontaine stage I–II cases to Fontaine stage III–IV cases decreased significantly (OR, 2.11; 95% CI, 1.26–3.59; P = 0.007) in 2020 compared to 2019 (Table 1).

Table 1.

Lower extremity procedures performed between March 15 and June 1 in 2019 and 2020

Procedures20192020Significance
Diagnostic angiographies
 AllN = 159N = 113OR, 1.27; 95% CI, 0.91–1.76; P = 0.184
 Fontaine stage IN = 3N = 1
 Fontaine stage IIN = 66N = 29
 Fontaine stage III–IVN = 90N = 83
 Fontaine stage I–II/Fontaine stage III–IV69/90 = 0.7730/83 = 0.36OR, 2.11; 95% CI, 1.26–3.59; P = 0.007
Therapeutic interventions
 AllN = 119N = 70OR, 0.92; 95% CI, 0.64–1.31; P = 0.696
 Fontaine stage IN = 0N = 2
 Fontaine stage IIN = 56N = 13
 Fontaine stage III–IVN = 63N = 55
 Fontaine stage I–II/Fontaine stage III–IV56/63 = 0.8915/55 = 0.27OR, 3.22; 95% CI, 1.67–6.52; P < 0.001

CI, Confidence interval; OR, odds ratio.

Among the therapeutic interventions, in 2020, 70 were lower extremity related (Fontaine stage I, N = 2; Fontaine stage II, N = 13; Fontaine stage III–IV, N = 55), while in 2019, 119 (Fontaine stage I, N = 0; Fontaine stage II, N = 56; Fontaine stage III–IV, N = 63). The number of lower extremity therapeutic interventions carried out in 2020 was non-significantly lower (OR, 0.92; 95% CI, 0.64–1.31; P = 0.696) than that in 2019. The ratio of Fontaine stage I–II cases to Fontaine stage III–IV cases decreased significantly (OR, 3.22; 95% CI, 1.67–6.52; P < 0.001) in 2020 compared to 2019 (Table 1).

The number of supra-aortic diagnostic angiographies and therapeutic interventions was significantly lower (P = 0.049) in 2020 (N = 18) than in 2019 (N = 51). As there were few cases in each diagnostic and therapeutic subgroup, no subgroup analysis was performed. The number of internal carotid artery (ICA) percutaneous transluminal angioplasty (PTA)/stenting/covered stent implantation, common carotid artery (CCA; proximal or middle) PTA/stenting/covered stent implantation, subclavian artery PTA/stenting, and innominate artery stenting in 2020 were five, four, two, and four, whereas those for 2019 were 28, five, four, and two, respectively (Table 2). PTA was performed only in patients with restenosis. In one patient, stent fracture with displacement was identified as the cause of ICA restenosis. The patient underwent surgical stent removal and the damaged carotid segment was replaced with a polytetrafluoroethylene interpositum (with end-to-end anastomosis of the ICA and CCA). Due to prolonged awakening, the patient had cranial computed tomography (CT) and carotid CT angiography (CTA) in the postoperative period. CTA showed significant stenosis at the distal anastomosis, which was treated with covered stent deployment. The other covered stent was implanted in a patient with iatrogenic CCA injury during a dialysis cannula insertion attempt.

Table 2.

Supra-aortic procedures performed between March 15 and June 1 in 2019 and 2020

Procedures20192020
All supra-aortic procedures (diagnostic + therapeutic), N5118
 Diagnostic angiographies, N122
  Bilateral carotid angiography, N72
  Four-vessel angiography, N50
 Therapeutic interventions, N3916
  ICA PTA, N10
  ICA stenting, N265
  ICA covered stent implantation, N10
  CCA PTA, N10
  CCA stenting, N41
  CCA covered stent implantation, N01
  Subclavian artery PTA, N11
  Subclavian artery stenting, N34
  Innominate artery stenting, N24

CCA, Common carotid artery, ICA, internal carotid artery, PTA, percutaneous transluminal angioplasty.

Other procedures include numerous types of diagnostic angiographies and therapeutic interventions (Table 3). The total number of these procedures was non-significantly lower (P = 0.487) in 2020 (N = 32) than in 2019 (N = 44). Due to the small number of cases in each diagnostic and therapeutic subgroup, no subgroup analysis was performed.

Table 3.

Other procedures performed between March 15 and June 1 in 2019 and 2020

Procedures20192020
All other procedures (diagnostic + therapeutic), N4432
 Diagnostic angiographies, N711
  Cavography, N20
  Hemodialysis access fistulography, N12
  Upper extremity angiography, N13
  Visceral angiography, N13
  Renovasography, N23
 Therapeutic interventions, N3721
  Superior vena caval stenting, N111
  Hemodialysis access PTA, N64
  Renal vein stenting, N10
  Celiac trunk stenting, N20
  Superior mesenteric artery stenting, N22
  Inferior mesenteric artery PTA, N01
  Inferior mesenteric artery stenting, N10
  Renal artery PTA, N01
  Renal artery stenting, N71
  Renal artery covered stent implantation, N01
  Embolization, N710

PTA, Percutaneous transluminal angioplasty.

As in 2019, during the first wave of the COVID-19 pandemic in 2020, those who had a diagnostic angiography were sent home or to the referring site after a short observation period, while those who underwent an intervention spent 24 hours in our institution.

Discussion

Our institution is a tertiary center for vascular and endovascular surgery with 50 beds. The referring territory is approximately 1.7 million. This is the largest such institution in Hungary having approximately 1,000 open surgical and 1,800 endosurgical procedures per year.

We have shown that the number of all lower extremity vascular procedures was lower during the first wave of the COVID-19 pandemic in 2020 than in the same period of 2019. However, there was no significant change in the number of emergency cases (Fontaine stages III and IV). Interventional procedures for those with intermittent claudication (Fontaine stage II) were postponed several weeks; in these cases, the delay did not risk the patients’ long-term health condition. So, the referral physicians were able to triage the patients in an adequate manner. A recent study revealed that the number of amputations is more than two-fold higher and the number of revascularizations is close to half in Hungary than that reported internationally; these numbers indicate the need to improve amputation prevention [5]. We have demonstrated that even in the COVID-19 era the number of patients with Fontaine stages III and IV has not decreased in our center. It should be noted that in patients with Fontaine stage I, diagnostic angiography or therapeutic intervention is normally not necessary. In our cohort, these were due to arterial aneurysms.

An online survey regarding the effect of the COVID-19 pandemic was sent to 365 vascular surgeons across the United States in April 2020 [6]. The COVID-19 pandemic has resulted in performing primarily emergency and urgent cases, and the number of elective operations was substantially reduced [6]. Moreover, a minority of vascular surgeons have been redeployed outside of their specialty; this was more common among states with high case numbers [6]. Similar results were observed in the United Kingdom in a survey for interventional radiologists: the COVID-19 outbreak has dramatically changed their practice in favor of mostly urgent endovascular care [7]. Comparable outcome was found in a tertiary academic center in Madrid; however, this study has not compared data of COVID-19 era to data of any pre-COVID-19 era [8].

In 2020, there were also far fewer therapeutic carotid interventions in our institution than in 2019. This is because stenting is mainly executed in the presence of asymptomatic stenosis, so these procedures could be postponed. Those treated invasively during the COVID-19 pandemic were symptomatic patients for whom surgery was contraindicated. Ultrasound-determined carotid stenosis is usually verified by CTA or by magnetic resonance angiography. Bilateral carotid digital subtraction angiography (DSA) was done with the intention of a therapeutic procedure; however, the therapeutic intervention was either unnecessary (the baseline DSA showed carotid artery occlusion or non-significant luminal narrowing in contrast to the CTA) or was not feasible for any unforeseen cause. Four-vessel cerebral angiographies were performed only to confirm brain death.

The number of embolization for acute bleeding also remained stable (10 in 2020, seven in 2019; Table 3), showing another field of patient group where emergency situations were well managed.

Patients, who underwent a therapeutic intervention were discharged from our institution only after 24 hours, regardless of the pandemic. In the Vascular and Endovascular Research Network (VERN) COVID-19 Vascular Service (COVER) Tier 2 Study, 1,103 procedures were analyzed and in 2% of the cases, a change in the choice of postoperative destination was reported. However, no further details on the change can be found in the article [9].

In conclusion, the first wave of the COVID-19 pandemic had a negative effect on the total number of endovascular procedures in the largest tertiary vascular center in Hungary.

Fig. 1.
Fig. 1.

Central Illustration. Lower extremity therapeutic interventions. The number of lower extremity therapeutic interventions for all patients (bars with crosslines) and for patients with Fontaine stage III–IV (dotted bars) in 2019 (left bars) and 2020 (right bars). The ratio of Fontaine stage I–II cases to Fontaine stage III–IV cases decreased significantly (OR, 3.22; 95% CI, 1.67–6.52; P < 0.001) in 2020 compared to 2019. LE, Lower extremity

Citation: IMAGING 2021; 10.1556/1647.2021.00032

Authors’ contribution

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Á.B., P.N.K., H.S., C.P., and E.D. The first draft of the manuscript was written by Á.B., V.B., and E.D., and all authors commented on previous versions of the manuscript. All authors read and approved the final version of the manuscript, and agreed to submit it to IMAGING for publication.

Funding sources

This article was funded by the EFOP-3.6.3-VEKOP-16-2017-00009 project (Ákos Bérczi).

Conflict of interests

The authors declared no potential conflict of interests with respect to the research, authorship, and/or publication of this article.

References

  • [1]

    Palmer K, Monaco A, Kivipelto M, Onder G, Maggi S, Michel J-P, et al.: The potential long-term impact of the COVID-19 outbreak on patients with non-communicable diseases in Europe: consequences for healthy ageing. Aging Clin Exp Res 2020; 32: 11891194.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • [2]

    Chandy PE, Nasir MU, Srinivasan S, Klass D, Nicolaou S, Babu SB: Interventional radiology and COVID-19: evidence-based measures to limit transmission. Diagn Interv Radiol 2020; 26: 236240.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • [3]

    Quek LHH, Tan GWL, Pua U: Managing endovascular workload during COVID-19 outbreak-the Singapore experience. Ann Vasc Surg 2020; 66: 35.

  • [4]

    Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FGR, et al.: Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg 2007; 45 Suppl S: S5–67.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • [5]

    Kolossváry E, Ferenci T, Kováts T, Kovács L, Szeberin Z, Sótonyi P, et al.: Lower limb amputations and revascularisation procedures in the Hungarian population: a 14 year retrospective cohort study. Eur J Vasc Endovasc Surg 2020; 59: 447456.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • [6]

    Latz CA, Boitano LT, Png CYM, Tanious A, Kibrik P, Conrad M, et al.: Early vascular surgery response to the COVID-19 pandemic: results of a nationwide survey. J Vasc Surg 2021; 73(2): 372380.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • [7]

    Rostampour S, Cleveland T, White H, Haslam P, McCafferty I, Hamady M: Response of UK interventional radiologists to the COVID-19 pandemic - survey findings. CVIR Endovasc 2020; 3: 41.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • [8]

    Reyes Valdivia A, Aracil Sanus E, Duque Santos Á, Gómez Olmos C, Gordillo Alguacil S, El Amrani M, et al.: Adapting vascular surgery practice to the current COVID-19 era at a tertiary academic center in Madrid. Ann Vasc Surg 2020; 67: 15.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • [9]

    Benson RA, Nandhra S: Outcomes of vascular and endovascular interventions performed during the coronavirus disease 2019 (COVID-19) pandemic. Ann Surg 2021; 273: 630635.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • [1]

    Palmer K, Monaco A, Kivipelto M, Onder G, Maggi S, Michel J-P, et al.: The potential long-term impact of the COVID-19 outbreak on patients with non-communicable diseases in Europe: consequences for healthy ageing. Aging Clin Exp Res 2020; 32: 11891194.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • [2]

    Chandy PE, Nasir MU, Srinivasan S, Klass D, Nicolaou S, Babu SB: Interventional radiology and COVID-19: evidence-based measures to limit transmission. Diagn Interv Radiol 2020; 26: 236240.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • [3]

    Quek LHH, Tan GWL, Pua U: Managing endovascular workload during COVID-19 outbreak-the Singapore experience. Ann Vasc Surg 2020; 66: 35.

  • [4]

    Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FGR, et al.: Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg 2007; 45 Suppl S: S5–67.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • [5]

    Kolossváry E, Ferenci T, Kováts T, Kovács L, Szeberin Z, Sótonyi P, et al.: Lower limb amputations and revascularisation procedures in the Hungarian population: a 14 year retrospective cohort study. Eur J Vasc Endovasc Surg 2020; 59: 447456.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • [6]

    Latz CA, Boitano LT, Png CYM, Tanious A, Kibrik P, Conrad M, et al.: Early vascular surgery response to the COVID-19 pandemic: results of a nationwide survey. J Vasc Surg 2021; 73(2): 372380.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • [7]

    Rostampour S, Cleveland T, White H, Haslam P, McCafferty I, Hamady M: Response of UK interventional radiologists to the COVID-19 pandemic - survey findings. CVIR Endovasc 2020; 3: 41.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • [8]

    Reyes Valdivia A, Aracil Sanus E, Duque Santos Á, Gómez Olmos C, Gordillo Alguacil S, El Amrani M, et al.: Adapting vascular surgery practice to the current COVID-19 era at a tertiary academic center in Madrid. Ann Vasc Surg 2020; 67: 15.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • [9]

    Benson RA, Nandhra S: Outcomes of vascular and endovascular interventions performed during the coronavirus disease 2019 (COVID-19) pandemic. Ann Surg 2021; 273: 630635.

    • Crossref
    • Search Google Scholar
    • Export Citation

 

The author instruction is available in PDF.
Please, download the file from HERE.
 
The Open Access statement together with the description of the Copyright and License Policy are available in PDF.
Please, download the file from HERE.


 

Chair of the Editorial Board:
Béla MERKELY (Semmelweis University, Budapest, Hungary)

Editor-in-Chief:
Pál MAUROVICH-HORVAT (Semmelweis University, Budapest, Hungary)

Deputy Editor-in-Chief:
Viktor BÉRCZI (Semmelweis University, Budapest, Hungary)

Executive Editor:
Charles S. WHITE (University of Maryland, USA)

Deputy Editors:
Gianluca PONTONE (Department of Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy)
Michelle WILLIAMS (University of Edinburgh, UK)

Senior Associate Editors:
Viktor BÉRCZI (Semmelweis University, Budapest, Hungary)
Tamás Zsigmond KINCSES (University of Szeged, Hungary)
Hildo LAMB (Leiden University, The Netherlands)
Denisa MURARU (Istituto Auxologico Italiano, IRCCS, Milan, Italy)
Ronak RAJANI (Guy’s and St Thomas’ NHS Foundation Trust, London, UK)

Associate Editors:
Andrea BAGGIANO (Department of Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy)
Fabian BAMBERG (Department of Radiology, University Hospital Freiburg, Germany)
Péter BARSI (Semmelweis University, Budapest, Hungary)
Theodora BENEDEK (University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania)
Ronny BÜCHEL (University Hospital Zürich, Switzerland)
Filippo CADEMARTIRI (SDN IRCCS, Naples, Italy) Matteo CAMELI (University of Siena, Italy)
Csilla CELENG (University of Utrecht, The Netherlands)
Edit DÓSA (Semmelweis University, Budapest, Hungary)
Marco FRANCONE (La Sapienza University of Rome, Italy)
Viktor GÁL (OrthoPred Ltd., Győr, Hungary)
Alessia GIMELLI (Fondazione Toscana Gabriele Monasterio, Pisa, Italy)
Tamás GYÖRKE (Semmelweis Unversity, Budapest)
Fabian HYAFIL (European Hospital Georges Pompidou, Paris, France)
György JERMENDY (Bajcsy-Zsilinszky Hospital, Budapest, Hungary)
Pál KAPOSI (Semmelweis University, Budapest, Hungary)
Mihaly KÁROLYI (University of Zürich, Switzerland)
Márton KOLOSSVÁRY (Semmelweis University, Budapest, Hungary)
Lajos KOZÁK (Semmelweis University, Budapest, Hungary)
Mariusz KRUK (Institute of Cardiology, Warsaw, Poland)
Zsuzsa LÉNARD (Semmelweis University, Budapest, Hungary)
Erica MAFFEI (ASUR Marche, Urbino, Marche, Italy)
Robert MANKA (University Hospital, Zürich, Switzerland)
Saima MUSHTAQ (Cardiology Center Monzino (IRCCS), Milan, Italy)
Gábor RUDAS (Semmelweis University, Budapest, Hungary)
Balázs RUZSICS (Royal Liverpool and Broadgreen University Hospital, UK)
Christopher L SCHLETT (Unievrsity Hospital Freiburg, Germany)
Bálint SZILVESZTER (Semmelweis University, Budapest, Hungary)
Richard TAKX (University Medical Centre, Utrecht, The Netherlands)
Ádám TÁRNOKI (National Institute of Oncology, Budapest, Hungary)
Dávid TÁRNOKI (National Institute of Oncology, Budapest, Hungary)
Jiayin ZHANG (Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China)
Hajnalka VÁGÓ (Semmelweis University, Budapest, Hungary)

International Editorial Board:

Gergely ÁGOSTON (University of Szeged, Hungary)
Anna BARITUSSIO (University of Padova, Italy)
Bostjan BERLOT (University Medical Centre, Ljubljana, Slovenia)
Edoardo CONTE (Centro Cardiologico Monzino IRCCS, Milan)
Réka FALUDI (University of Szeged, Hungary)
Andrea Igoren GUARICCI (University of Bari, Italy)
Marco GUGLIELMO (Department of Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy)
Kristóf HISRCHBERG (University of Heidelberg, Germany)
Dénes HORVÁTHY (Semmelweis University, Budapest, Hungary)
Julia KARADY (Harvard Unversity, MA, USA)
Attila KOVÁCS (Semmelweis University, Budapest, Hungary)
Riccardo LIGA (Cardiothoracic and Vascular Department, Università di Pisa, Pisa, Italy)
Máté MAGYAR (Semmelweis University, Budapest, Hungary)
Giuseppe MUSCOGIURI (Centro Cardiologico Monzino IRCCS, Milan, Italy)
Anikó I NAGY (Semmelweis University, Budapest, Hungary)
Liliána SZABÓ (Semmelweis University, Budapest, Hungary)
Özge TOK (Memorial Bahcelievler Hospital, Istanbul, Turkey)
Márton TOKODI (Semmelweis University, Budapest, Hungary)

Managing Editor:
Anikó HEGEDÜS (Semmelweis University, Budapest, Hungary)

Pál Maurovich-Horvat, MD, PhD, MPH, Editor-in-Chief

Semmelweis University, Medical Imaging Centre
2 Korányi Sándor utca, Budapest, H-1083, Hungary
Tel: +36-20-663-2485
E-mail: maurovich-horvat.pal@med.semmelweis-univ.hu

Indexing and Abstracting Services:

  • Scopus

2020  
CrossRef Documents 7
CrossRef Cites 0
CrossRef H-index 1
Days from submission to acceptance 17
Days from acceptance to publication 70
Acceptance Rate 43%

Imaging
Publication Model Gold Open Access
Submission Fee none
Article Processing Charge none
Regional discounts on country of the funding agency  
Further Discounts  
Subscription Information Gold Open Access
Purchase per Title  

Imaging
Language English
Size A4
Year of
Foundation
2020 (2009)
Publication
Programme
2020 Volume 12
Volumes
per Year
1
Issues
per Year
2
Founder Akadémiai Kiadó
Founder's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 2732-0960 (Online)

Monthly Content Usage

Abstract Views Full Text Views PDF Downloads
May 2021 0 0 0
Jun 2021 0 19 17
Jul 2021 0 133 123
Aug 2021 0 126 124
Sep 2021 0 73 77
Oct 2021 0 10 14
Nov 2021 0 0 0