Anesthésie générale ou sédation consciente pour la thrombectomie chez les personnes victimes d’un accident vasculaire cérébral : une mise à jour sous forme de revue systématique avec méta-analyse

Geraldini, Federico; Diana, Paolo; Fregolent, Davide; De Cassai, Alessandro; Boscolo, Annalisa; Pettenuzzo, Tommaso; Sella, Nicolò; Lupelli, Irene; Navalesi, Paolo; Munari, Marina

doi:10.1007/s12630-023-02481-8

Cited by 3 publications

(3 citation statements)

References 49 publications

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“…The findings of this study are in step with recent systematic reviews and meta-analyses by Geraldini et al 25 In this study, 1,342 patients from nine RCTs were included in the analysis. No significant differences were detected between GA or sedation with regard to functional independence post-EVT (mRS score 0–2), procedure duration, stroke onset to reperfusion time, mortality, and hospital or ICU length of stay.…”

Section: General Anesthesia Versus Sedation For Patients Undergoing Evtsupporting

confidence: 77%

Year in Review: Synopsis of Selected Articles in Neuroanesthesia and Neurocritical Care from 2023

Hayes,

Nijs,

Venkatraghavan

2024

J Neuroanaesth Crit Care

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This review is a synopsis of selected articles from neuroscience, neuroanesthesia, and neurocritical care from 2023 (January–November 2023). The journals reviewed include anesthesia journals, critical care medicine journals, neurosurgical journals as well as high-impact medical journals such as the Lancet, Journal of American Medical Association, New England Journal of Medicine, and Stroke. The summary of important articles will serve to update the knowledge of neuroanesthesiologists and other perioperative physicians who provide care to neurosurgical and neurocritical patients.

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Section: General Anesthesia Versus Sedation For Patients Undergoing Evtsupporting

confidence: 77%

Year in Review: Synopsis of Selected Articles in Neuroanesthesia and Neurocritical Care from 2023

Hayes,

Nijs,

Venkatraghavan

2024

J Neuroanaesth Crit Care

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“…A recent meta-analysis 6 also reported significantly higher recanalization rates in patients under GA; however, this meta-analysis included only preliminary data from the trial by Liang et al 11 and did not include a recently published RCT. Our meta-analysis aligns with previous prospective studies that showed worse results in patients treated with CS.…”

Section: Discussionmentioning

confidence: 99%

“…However, these findings come from observational and preliminary studies 5 6 and several randomized trials that reported either no difference or a slight improvement in infarct size or other clinical outcomes with GA, while some retrospective and prospective observational studies have reported worse outcomes with GA for mechanical thrombectomy. A recent 2023 randomized clinical trial explored the impact of anesthesia or sedation on periprocedural complications and functional outcomes.…”

Section: Introductionmentioning

confidence: 99%

General anesthesia versus conscious sedation in mechanical thrombectomy for patients with acute ischemic stroke: systematic review and meta-analysis

Santos,

Coelho,

Caldas

et al. 2024

Arq Neuropsiquiatr

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Background After recently published randomized clinical trials, the choice of the best anesthetic procedure for mechanical thrombectomy (MT) in acute ischemic stroke (AIS) due to large vessel occlusion (LVO) is not definite. Objective To compare the efficacy and safety of general anesthesia (GA) versus conscious sedation (CS) in patients with AIS who underwent MT, explicitly focusing on procedural and clinical outcomes and the incidence of adverse events. Methods PubMed, Embase, and Cochrane were systematically searched for randomized controlled trials (RCTs) comparing GA versus CS in patients who underwent MT due to LVO-AIS. Odds ratios (ORs) were calculated for binary outcomes, with 95% confidence intervals (CIs). Random effects models were used for all outcomes. Heterogeneity was assessed with I2 statistics. Results Eight RCTs (1,300 patients) were included, of whom 650 (50%) underwent GA. Recanalization success was significantly higher in the GA group (OR 1.68; 95% CI 1.26–2.24; p < 0.04) than in CS. No significant difference between groups were found for good functional recovery (OR 1.13; IC 95% 0.76–1.67; p = 0.56), incidence of pneumonia (OR 1.23; IC 95% 0.56- 2,69; p = 0.61), three-month mortality (OR 0.99; IC 95% 0.73–1.34; p = 0.95), or cerebral hemorrhage (OR 0.97; IC 95% 0.68–1.38; p = 0.88). Conclusion Despite the increase in recanalization success rates in the GA group, GA and CS show similar rates of good functional recovery, three-month mortality, incidence of pneumonia, and cerebral hemorrhage in patients undergoing MT.

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Treatment of Acute Ischemic Stroke: The Last 30 Years of Trials and Tribulations

Jan,

Chong

2024

Cardiology in Review

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The landscape of acute ischemic stroke management has undergone a substantial transformation over the past 3 decades, mirroring our enhanced comprehension of the pathology and progress in diagnostic techniques, therapeutic interventions, and preventive measures. The 1990s marked a pivotal moment in stroke care with the integration of intravenous thrombolytics. However, the most significant paradigm shift in recent years has undoubtedly been the advent of endovascular thrombectomy. This article endeavors to deliver an exhaustive analysis of this revolutionary progression.

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Anesthésie générale ou sédation consciente pour la thrombectomie chez les personnes victimes d’un accident vasculaire cérébral : une mise à jour sous forme de revue systématique avec méta-analyse

Cited by 3 publications

References 49 publications

Year in Review: Synopsis of Selected Articles in Neuroanesthesia and Neurocritical Care from 2023

Year in Review: Synopsis of Selected Articles in Neuroanesthesia and Neurocritical Care from 2023

General anesthesia versus conscious sedation in mechanical thrombectomy for patients with acute ischemic stroke: systematic review and meta-analysis

Treatment of Acute Ischemic Stroke: The Last 30 Years of Trials and Tribulations

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