Type of anaesthesia for acute ischaemic stroke endovascular treatment

Tosello, Renato Tavares; Riera, Rachel; Tosello, Giuliano; Clezar, Caroline Nb; Amorim, Jorge Eduardo de; Vasconcelos, Vladimir; Joao, Benedito B; Flumignan, Ronald Luiz Gomes

doi:10.1002/14651858.cd013690

Cited by 2 publications

(4 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…39 Our results in RCTs were consistent with Tosello's meta-analysis: GA had a higher possibility of SR in the short term and did not influence FI and mortality in the long term (90 days). 40 Compared with previous studies, our findings included more recent real-world studies and RCTs (CANVAS II 41 and AMETIS trial 42 ). Furthermore, our study focused more on studies based on AIS in the posterior circulation.…”

Section: Discussionmentioning

confidence: 99%

General anesthesia versus nongeneral anesthesia during endovascular therapy for acute ischemic stroke: A systematic review and meta‐analysis

Wang,

Wu,

Liang

et al. 2023

J Evidence Based Medicine

View full text Add to dashboard Cite

ObjectiveThis study compares the safety and efficacy of general anesthesia (GA) and nongeneral anesthesia (non‐GA) on functional outcomes in patients receiving endovascular therapy for ischemic stroke.MethodsAll available studies on the anesthetic management of patients with acute ischemic stroke in PubMed, the Cochrane Central Register of Controlled Trials, and Embase were included. We also compared the clinical outcomes in the studies with subgroup analyses of the occlusion site (anterior vs. posterior circulation) and preretriever group versus retriever group. Functional independence, mortality, successful recanalization, hemodynamic instability, intracerebral hemorrhage, and respiratory complications were considered primary or secondary outcomes.ResultsA total of 24,606 patients in 60 studies were included. GA had a lower risk of 90‐day functional independence (OR = 0.67, 95% CI 0.58 to 0.77), higher risk of 90‐day mortality (OR = 1.29; 95% CI 1.15 to 1.45), and successful reperfusion (OR = 1.18; 95% CI 1.94 to 6.82). However, there were no differences in functional independence and mortality between GA and non‐GA at 90 days after the procedure.ConclusionThe study shows poorer results in the GA group, which may be due to the inclusion of nonrandomized studies. However, analysis of the RCTs suggested that the outcomes do not differ between the two groups (GA vs. non‐GA). Thus, general anesthesia is as safe as nongeneral anesthesia under standardized management.

show abstract

Section: Discussionmentioning

confidence: 99%

General anesthesia versus nongeneral anesthesia during endovascular therapy for acute ischemic stroke: A systematic review and meta‐analysis

Wang,

Wu,

Liang

et al. 2023

J Evidence Based Medicine

View full text Add to dashboard Cite

show abstract

“…In a recent meta-analysis including six of those trials, general anaesthesia was associated with higher rates of favourable outcome and successful recanalization (45.5 versus 37.4% and 85.7 versus 75.7%, respectively) [24]. The major potentials hazards of general anaesthesia are procedural delay and drop of the arterial blood pressure [22 ▪ ,23]. The delay in DTP is probably offset by an improved puncture to recanalization time under general anaesthesia.…”

Section: Pre-procedural Managementmentioning

confidence: 99%

“…Currently, the preferred type of anaesthesia during EVT is still debatable [22 ▪ ]. Three main anaesthetic techniques are used during EVT: General anaesthesia, conscious sedation (with or without local anaesthesia) and local anaesthesia only.…”

Section: Pre-procedural Managementmentioning

confidence: 99%

“…Trained EVT anaesthesiologists and adherence to blood pressure targeted protocols may significantly reduce arterial pressure drops. Furthermore, general anaesthesia is associated with less hemodynamic instability compared with conscious sedation [22 ▪ ]. Few ongoing trials currently examine the recommended arterial pressure during EVT.…”

Section: Pre-procedural Managementmentioning

confidence: 99%

See 1 more Smart Citation

Current advances in endovascular treatment

Molad

Honig

2023

Current Opinion in Neurology

View full text Add to dashboard Cite

Purpose of reviewEndovascular thrombectomy (EVT) is the most beneficial reperfusion therapy for acute ischemic stroke. Currently, much effort is done to promote trials examining EVT efficacy and safety in various conditions not included in the main randomized controlled trials established the superiority of EVT. This review summarizes the current advances of EVT patients selection and periprocedural management. Recent findingsRecent evidence points to beneficial effect of EVT among patients with relatively large ischemic core, premorbid independent nonagenarians and basilar artery occlusion, and suggest that intravenous thrombolysis bridging treatment is associated with better reperfusion rates. Ongoing trials currently examine EVT efficacy and safety in distal vessel occlusions and in large vessel occlusion with low NIHSS. Current evidence also support use of general anaesthesia and avoid postprocedural extremely low or high blood pressure as well as haemodynamic instability.

show abstract

Type of anaesthesia for acute ischaemic stroke endovascular treatment

Cited by 2 publications

References 45 publications

General anesthesia versus nongeneral anesthesia during endovascular therapy for acute ischemic stroke: A systematic review and meta‐analysis

General anesthesia versus nongeneral anesthesia during endovascular therapy for acute ischemic stroke: A systematic review and meta‐analysis

Current advances in endovascular treatment

Contact Info

Product

Resources

About