General Anesthesia Versus Conscious Sedation and Local Anesthesia During Thrombectomy for Acute Ischemic Stroke.

Stroke; a Journal of Cerebral Circulation
Manuel CappellariSalvatore Mangiafico

Abstract

As numerous questions remain about the best anesthetic strategy during thrombectomy, we assessed functional and radiological outcomes in stroke patients treated with thrombectomy in presence of general anesthesia (GA) versus conscious sedation (CS) and local anesthesia (LA). We conducted a cohort study on prospectively collected data from 4429 patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke. GA was used in 2013 patients, CS in 1285 patients, and LA in 1131 patients. The rates of 3-month modified Rankin Scale score of 0-1 were 32.7%, 33.7%, and 38.1% in the GA, CS, and LA groups: GA versus CS: odds ratios after adjustment for unbalanced variables (adjusted odds ratio [aOR]), 0.811 (95% CI, 0.602-1.091); and GA versus LA: aOR, 0.714 (95% CI, 0.515-0.990). The rates of modified Rankin Scale score of 0-2 were 42.5%, 46.6%, and 52.4% in the GA, CS, and LA groups: GA versus CS: aOR, 0.902 (95% CI, 0.689-1.180); and GA versus LA: aOR, 0.769 (95% CI, 0.566-0.998). The rates of 3-month death were 21.5%, 19.7%, and 14.8% in the GA, CS, and LA groups: GA versus CS: aOR, 0.872 (95% CI, 0.644-1.181); and GA versus LA: aOR, 1.235 (95% CI, 0.844-1.807). The rates of parenchymal hematoma were 9%, 12.6%, and ...Continue Reading

References

Mar 29, 2014·Stroke; a Journal of Cerebral Circulation·Alex Abou-CheblRaul G Nogueira
Dec 18, 2014·The New England Journal of Medicine·Olvert A BerkhemerUNKNOWN MR CLEAN Investigators
Feb 12, 2015·The New England Journal of Medicine·Bruce C V CampbellUNKNOWN EXTEND-IA Investigators
Feb 12, 2015·The New England Journal of Medicine·Mayank GoyalUNKNOWN ESCAPE Trial Investigators
Apr 18, 2015·The New England Journal of Medicine·Jeffrey L SaverUNKNOWN SWIFT PRIME Investigators
Apr 18, 2015·The New England Journal of Medicine·Tudor G JovinUNKNOWN REVASCAT Trial Investigators
May 20, 2017·Stroke; a Journal of Cerebral Circulation·Pia Löwhagen HendénSven-Erik Ricksten
Sep 15, 2017·Stroke; a Journal of Cerebral Circulation·Waleed BrinjikjiAlejandro A Rabinstein
Jan 10, 2018·Stroke; a Journal of Cerebral Circulation·Manuel CappellariDanilo Toni
Mar 16, 2018·International Journal of Stroke : Official Journal of the International Stroke Society·Manuel CappellariDanilo Toni
Jun 3, 2018·Neurology·Rob A van de GraafUNKNOWN Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) Regis
Sep 28, 2018·Journal of Neurology, Neurosurgery, and Psychiatry·Guillaume GravelOlivier N Naggara
May 11, 2019·AJNR. American Journal of Neuroradiology·C J PowersM P Marks
Jun 25, 2019·Stroke; a Journal of Cerebral Circulation·Manuel CappellariUNKNOWN Listing of IER Collaborators

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Citations

Jul 21, 2020·Expert Review of Cardiovascular Therapy·Ankur WadhwaBijoy Menon
Dec 23, 2020·Stroke; a Journal of Cerebral Circulation·Stéphane ChabrierManoëlle Kossorotoff
Jan 23, 2021·Journal of Neurosurgical Anesthesiology·Jeffrey J Pasternak
Apr 27, 2021·Neurologic Clinics·Anil RamineniAla Nozari
Sep 14, 2021·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Adrien GuenegoBoris Lubicz

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