Is blood pressure maintenance more important than type of anaesthesia for patients undergoing mechanical thrombectomy after ischaemic stoke?

Wiles, M. D.

doi:10.1111/anae.14974

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…BP goals and potential (not documented) BP drops might explain some of the inconsistencies in the available data. After all, “the conduct rather than the method of anesthesia” might determine outcomes [ 95 ]. No general recommendations exist regarding which method to use.…”

Section: Discussionmentioning

confidence: 99%

What You Always Wanted to Know about Endovascular Therapy in Acute Ischemic Stroke but Never Dared to Ask: A Comprehensive Review

Bücke¹,

Cohen²,

Horvath³

et al. 2022

Rev. Cardiovasc. Med.

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In 2015, mechanical thrombectomy (MT) in combination with intravenous thrombolysis was demonstrated to be superior to best medical treatment alone in patients with anterior circulation stroke. This finding resulted in an unprecedented boost in endovascular stroke therapy, and MT became widely available. MT was initially approved for patients presenting with large vessel occlusion in the anterior circulation (intracranial internal carotid artery or proximal middle cerebral artery) within a 6-hour time window. Eventually, it was shown to be beneficial in a broader group of patients, including those without known symptom-onset, wake-up stroke, or patients with posterior circulation stroke. Technical developments and the implementation of novel thrombectomy devices further facilitated endovascular recanalization for acute ischemic stroke. However, some aspects remain controversial. Is MT suitable for medium or very distal vessel occlusions? Should emergency stenting be performed for symptomatic stenosis or recurrent occlusion? How should patients with large vessel occlusion without disabling symptoms be treated? Do certain patients benefit from MT without intravenous thrombolysis? In the era of personalized decision-making, some of these questions require an individualized approach based on comorbidities, imaging criteria, and the severity or duration of symptoms. Despite its successful development in the past decade, endovascular stroke therapy will remain a challenging and fascinating field in the years to come. This review aims to provide an overview of patient selection, and the indications for and execution of MT in patients with acute ischemic stroke.

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Section: Discussionmentioning

confidence: 99%

What You Always Wanted to Know about Endovascular Therapy in Acute Ischemic Stroke but Never Dared to Ask: A Comprehensive Review

Bücke¹,

Cohen²,

Horvath³

et al. 2022

Rev. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…An accompanying editorial [4] proposes it is the ‘how’, not the ‘what’ that is more important during anaesthetic intervention for endovascular thrombectomy. What Deng et al.…”

mentioning

confidence: 99%

Anaesthetic preferences for endovascular stroke thrombectomy

2020

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“…The main finding of the study by Deng et al is that a definitive randomised controlled trial of standard vs. augmented systolic blood pressure management during endovascular thrombectomy is warranted scientifically and is feasible, with a target sample size of 550 patients. The clinical uncertainty associated with this topic is nuanced in the accompanying editorial [6], and Deng et al were careful not to overinterpret their results. As such, we argue the study by Deng et al represents an excellent example of what a pilot study should look like, and we strongly disagree with Muggleton that it misguides clinicians.…”

mentioning

confidence: 99%