2010
DOI: 10.1161/strokeaha.109.574129
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Abstract: Background and Purpose-Patients undergoing intra-arterial therapy (IAT) for acute ischemic stroke receive either general anesthesia (GA) or conscious sedation. GA may delay time to treatment, whereas conscious sedation may result in patient movement and compromise the safety of the procedure. We sought to determine whether there were differences in safety and outcomes in GA patients before initiation of IAT. Methods-A cohort of 980 patients at 12 stroke centers underwent IAT for acute stroke between 2005 and 2… Show more

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Cited by 303 publications
(275 citation statements)
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“…Others have argued that IAT should be performed under GA to make the procedure safer by avoiding inadvertent wire perforation due to patient motion. A recent study by the author (Abou-Chebl [33]) and his colleagues casts doubt into the validity of these concerns. In a pooled analysis of 980 consecutive patients from 12 medical centers receiving IAT, those treated under GA had a greater than 2-fold risk of poor outcomes and a nearly 2-fold risk of death [33].…”
Section: Peri-procedural Medical Managementmentioning
confidence: 99%
See 1 more Smart Citation
“…Others have argued that IAT should be performed under GA to make the procedure safer by avoiding inadvertent wire perforation due to patient motion. A recent study by the author (Abou-Chebl [33]) and his colleagues casts doubt into the validity of these concerns. In a pooled analysis of 980 consecutive patients from 12 medical centers receiving IAT, those treated under GA had a greater than 2-fold risk of poor outcomes and a nearly 2-fold risk of death [33].…”
Section: Peri-procedural Medical Managementmentioning
confidence: 99%
“…A recent study by the author (Abou-Chebl [33]) and his colleagues casts doubt into the validity of these concerns. In a pooled analysis of 980 consecutive patients from 12 medical centers receiving IAT, those treated under GA had a greater than 2-fold risk of poor outcomes and a nearly 2-fold risk of death [33]. Importantly, those treated while awake did not have any increase in the risk of ICH or wire perforation.…”
Section: Peri-procedural Medical Managementmentioning
confidence: 99%
“…However, data from multiple retrospective studies show a correlation between the use of general anesthesia (GA) and worse outcome. For example, one multicenter study showed that GA was associated with worse functional outcomes as assessed by the mRS than monitored anesthesia care (MAC), based on data from 980 patients who underwent mechanical recanalization (13). Other retrospective studies have come to similar conclusions, with GA associated with worse functional outcomes (i.e., a mRS score >2) (14,15), parenchymal hemorrhage (16), and higher in-hospital mortality (16).…”
Section: General Anesthesia Versus Monitored Anesthesia Care For Mechmentioning
confidence: 97%
“…Patients receiving GA may harbor a cerebral infarct that is more extensive and advanced, are unable to cooperate or protect their airways, or have other major comorbidities. Indeed, in many of these retrospective studies, patients receiving GA had higher pre-procedural National Institutes of Health Stroke Scale (NI-HSS) scores, indicating that they had more symptomatic strokes prior to endovascular intervention (13)(14)(15). The difference in baseline neurological status is an independent predictor of worse outcomes, including death (14,16).…”
Section: General Anesthesia Versus Monitored Anesthesia Care For Mechmentioning
confidence: 99%
“…In Analogie zu Jumaa et al [10] fand sich in der vorliegenden Studie sowohl bei Verschlüssen im vorderen (6,5 ± 3,7 Tage vs. 9,6 ± 4,1 Tage) als auch im hinteren (6,3 ± 2,9 Tage vs. 7,9 ± 3,7 [24]. In 2 weiteren aktuellen Studien konnte die Korrelation zwischen Intubationsnarkose und schlechterem klinischem Outcome bestätigt werden [25,26]. Eine mögliche weitere Erklärung hierfür ist, dass sich die Penumbra in Abhängigkeit von der Dauer fehlender Reperfusion zugunsten des Infarktkerns zurückbildet und hieraus ein schlechteres Outcome resultiert [10].…”
Section: Introductionunclassified