Choice of ANesthesia for EndoVAScular Treatment of Acute Ischemic Stroke: Protocol for a randomized controlled (CANVAS) trial

Peng, Yuming; Li, Yan; Jian, Minyu; Liu, Xiaoyuan; Sun, Jian; Jia, Bo; Dong, Jing; Zeng, Min; Lin, Nan; Zhang, Li; Gelb, Adrian W.; Chan, Matthew T. V.; Han, Ruquan

doi:10.1177/1747493017706243

Cited by 17 publications

(9 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Concurrent ongoing trials with day 90 mRS as a primary outcome are planning to recruit 635 patients to demonstrate non-inferiority between CS and GA,36 350 patients to demonstrate superiority of CS versus GA (NCT02822144) or 260 patients to demonstrate superiority of GA versus CS (NCT03263117).…”

Section: Discussionmentioning

confidence: 99%

Sedation versus general anaesthesia in endovascular therapy for anterior circulation acute ischaemic stroke: the multicentre randomised controlled AMETIS trial study protocol

et al. 2019

View full text Add to dashboard Cite

IntroductionEndovascular thrombectomy is the standard of care for anterior circulation acute ischaemic stroke (AIS) secondary to emergent large vessel occlusion in patients who qualify. General anaesthesia (GA) or conscious sedation (CS) is usually required to ensure patient comfort and avoid agitation and movement during thrombectomy. However, the question of whether the use of GA or CS might influence functional outcome remains debated. Indeed, conflicting results exist between observational studies with better outcomes associated with CS and small monocentric randomised controlled trials favouring GA. Therefore, we aim to evaluate the effect of CS versus GA on functional outcome and periprocedural complications in endovascular mechanical thrombectomy for anterior circulation AIS.Methods and analysisAnesthesia Management in Endovascular Therapy for Ischemic Stroke (AMETIS) trial is an investigator initiated, multicentre, prospective, randomised controlled, two-arm trial. AMETIS trial will randomise 270 patients with anterior circulation AIS in a 1:1 ratio, stratified by centre, National Institutes of Health Stroke Scale (≤15 or >15) and association of intravenous thrombolysis or not to receive either CS or GA. The primary outcome is a composite of functional independence at 3 months and absence of perioperative complication occurring by day 7 after endovascular therapy for anterior circulation AIS. Functional independence is defined as a modified Rankin Scale score of 0–2 by day 90. Perioperative complications are defined as intervention-associated arterial perforation or dissection, pneumonia or myocardial infarction or cardiogenic acute pulmonary oedema or malignant stroke evolution occurring by day 7.Ethics and disseminationThe AMETIS trial was approved by an independent ethics committee. Study began in august 2017. Results will be published in an international peer-reviewed medical journal.Trial registration numberNCT03229148.

show abstract

Section: Discussionmentioning

confidence: 99%

Sedation versus general anaesthesia in endovascular therapy for anterior circulation acute ischaemic stroke: the multicentre randomised controlled AMETIS trial study protocol

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Plasma glucose will be maintained at level of 140-180 mg/dL while SpO 2 is aimed to be over 94%, with FiO 2 at a range from 40% to 60%. 27 It is anticipated that patients in the CS group may deteriorate during EVT and may, therefore, require endotracheal intubation or laryngeal mask insertion for airway protection. 17 All anaesthesia-related treatment will be performed by anaesthesiologists of ischaemia stroke team.…”

Section: Standard Anaesthesia Management Protocols During Evt (Concommentioning

confidence: 99%

“…Anaesthesia will be induced with infusion of propofol of 1-2 mg/kg and remifentanil of 0.2-0.8 ug/ kg for anaesthesia induction. 27 Muscle relaxation will be achieved with rocuronium (0.6 mg/kg). After endotracheal intubation or laryngeal mask insertion, suction will be performed to mitigate risk of aspiration.…”

Section: Standard Anaesthesia Management Protocols During Evt (Concommentioning

confidence: 99%

Choice of ANaesthesia for EndoVAScular treatment of acute ischaemic stroke at posterior circulation (CANVAS II): protocol for an exploratory randomised controlled study

et al. 2020

Self Cite

View full text Add to dashboard Cite

IntroductionObservational and interventional studies indicate that the type of anaesthesia may be associated with the postprocedural neurological function in patients with anterior circulation acute ischaemic stroke undergoing endovascular treatment. Patients with acute posterior circulation ischaemic stroke may experience different physiological changes and result in severe neurological outcome. However, the effect of the type of anaesthesia on postprocedure neurological function remained unclear in this population.Methods and analysisThis is an exploratory randomised controlled trial that will be carried out at Beijing Tiantan Hospital, Capital Medical University. Patients with acute posterior circulation ischaemic stroke and deemed suitable for emergency endovascular recanalisation will be recruited in this trial. Eighty-four patients will be randomised to receive either general anaesthesia or conscious sedation with 1:1 allocation ratio. The primary endpoint is the 90-day modified Rankin Scale.Ethics and disseminationThe study has been reviewed by and approved by Ethics Committee of Beijing Tiantan Hospital of Capital Medical University (KY2017-074-02). If the results are positive, the study will indicate whether the type of anaesthesia affects neurological outcome after endovascular treatment of posterior stroke. The findings of the study will be published in peer-reviewed journals and presented at national or international conferences.Trial registration numberNCT03317535.

show abstract

“…Although such efforts will not unambiguously settle whether these doses and studies are too small to detect signs of clinical neurotoxicity, they serve as a foundation for better addressing the issue in the older brain, and could reveal whether large, clinically significant effects become readily apparent during a period of known neural vulnerability. Additional prospective efforts are ongoing, 35 and multidisciplinary collaboration may be key to answering these questions.…”

Section: New Scientific Model For Anaesthetic Neurotoxicity?mentioning

confidence: 99%

Reconceptualising stroke research to inform the question of anaesthetic neurotoxicity

Vlisides

Avidan

Mashour

2018

British Journal of Anaesthesia

View full text Add to dashboard Cite

Choice of ANesthesia for EndoVAScular Treatment of Acute Ischemic Stroke: Protocol for a randomized controlled (CANVAS) trial

Abstract: ClinicalTrial.gov identifier: NCT02677415.

Cited by 17 publications

References 35 publications

Sedation versus general anaesthesia in endovascular therapy for anterior circulation acute ischaemic stroke: the multicentre randomised controlled AMETIS trial study protocol

Sedation versus general anaesthesia in endovascular therapy for anterior circulation acute ischaemic stroke: the multicentre randomised controlled AMETIS trial study protocol

Choice of ANaesthesia for EndoVAScular treatment of acute ischaemic stroke at posterior circulation (CANVAS II): protocol for an exploratory randomised controlled study

Reconceptualising stroke research to inform the question of anaesthetic neurotoxicity

Contact Info

Product

Resources

About