General anesthesia versus conscious sedation during endovascular treatment in posterior circulation large vessel occlusion: A systematic review and meta-analysis

Terceño, Mikel; Viturro, Saima Bashir; Cienfuegos, Juan; Murillo, Alan; Vera-Monge, Víctor A; Pardo, Laura; Montserrat, Reina; Gubern-Mérida, Carme; Puigoriol-Illamola, Dolors; Carballo, Laia; Costa, Anna Caroline Leite; Buxó, María; Serena, Joaquı́n; Silva, Yolanda

doi:10.1177/23969873221127738

Cited by 4 publications

(2 citation statements)

References 30 publications

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“…Interestingly, some studies found that general anesthesia was associated with higher recanalization rates 46,47 . In our study, general anesthesia, together with unsuccessful recanalization, were risk factors for post‐EVT infection, which may be due to the effect of mechanical ventilation and sedation under general anesthesia 48,49 …”

Section: Discussionmentioning

confidence: 55%

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Outcomes and risk factors for infection after endovascular treatment in patients with acute ischemic stroke

Jiang,

Hu,

Wang

et al. 2024

CNS Neurosci Ther

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AimsInfection is a common complication following acute ischemic stroke (AIS) and significantly contributes to poor functional outcomes after stroke. This study aimed to investigate the effects of infection after endovascular treatment (post‐EVT infection) on clinical outcomes and risk factors in patients with AIS.MethodsWe retrospectively analyzed AIS patients treated with endovascular treatment (EVT) between January 2016 and December 2022. A post‐EVT infection was defined as any infection diagnosed within 7 days after EVT. The primary outcome was functional independence, defined as a modified Rankin scale (mRS) score of 0–2 at 90 days. A multivariable logistic regression analysis was conducted to determine independent predictors of post‐EVT infection and the associations between post‐EVT infection and clinical outcomes.ResultsA total of 675 patients were included in the analysis; 306 (45.3%) of them had post‐EVT infections. Patients with post‐EVT infection had a lower rate of functional independence than patients without infection (31% vs 65%, p = 0.006). In addition, patients with post‐EVT infection achieved less early neurological improvement (ENI) after EVT (25.8% vs 47.4%, p < 0.001). For safety outcomes, the infection group had a higher incidence of any intracranial hemorrhage (23.9% vs 15.7%, p = 0.01) and symptomatic intracranial hemorrhage (10.1% vs 5.1%, p = 0.01). Unsuccessful recanalization (aOR 1.87, 95% CI 1.11–3.13; p = 0.02) and general anesthesia (aOR 2.22, 95% CI 1.25–3.95; p = 0.01) were identified as independent predictors for post‐EVT infection in logistic regression analysis.ConclusionAIS patients who develop post‐EVT infections are more likely to experience poor clinical outcomes. Unsuccessful recanalization and general anesthesia were independent risk factors for the development of post‐EVT infection.

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Section: Discussionmentioning

confidence: 55%

“…46,47 In our study, general anesthesia, together with unsuccessful recanalization, were risk factors for post-EVT infection, which may be due to the effect of mechanical ventilation and sedation under general anesthesia. 48,49 To the best of our knowledge, this is the first study that directly…”

Section: Discussionmentioning

confidence: 96%

Outcomes and risk factors for infection after endovascular treatment in patients with acute ischemic stroke

Jiang,

Hu,

Wang

et al. 2024

CNS Neurosci Ther

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Outcomes with General Anesthesia Compared to Conscious Sedation for Endovascular Treatment of Medium Vessel Occlusions: Results of an International Multicentric Study

Radu,

Costalat,

Romoli

et al. 2024

Clin Neuroradiol

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Endovascular Treatment in Acute Basilar Artery Occlusion Stroke: A Brief Practice Update From the Society of Vascular and Interventional Neurology

Asif,

Novakovic,

Nguyen

et al. 2023

SVIN

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BACKGROUND The Society of Vascular and Interventional Neurology Guidelines and Practice Standards committee established the “Brief Practice Update” format to provide up‐to‐date recommendations on focused relevant clinical questions. In this Brief Practice Update, we review current evidence and provide recommendations for endovascular treatment (EVT) in patients with acute large‐vessel occlusion of the basilar artery. METHODS The Society of Vascular and Interventional Neurology Guidelines and Practice Standards committee conducted a systematic review, including the recent randomized clinical trials of EVT for acute ischemic stroke attributable to basilar artery occlusion, and summarized relevant data to provide recommendations for clinical practice. The Guidelines and Practice Standards quality committee reviewed the findings to ensure adherence to the Society of Vascular and Interventional Neurology internal evidence evaluation guidelines before review by the Society of Vascular and Interventional Neurology board members for societal endorsement. RESULTS Evidence favors EVT for basilar artery occlusion in comparison to medical management alone in patients with moderate to severe stroke. We formulated the level of evidence and the class of recommendation in the context of 5 clinical questions. CONCLUSIONS In this brief practice statement, we share general recommendations on EVT for acute ischemic stroke attributable to large‐vessel occlusion of the basilar artery. Recent randomized controlled trials, Basilar Artery Occlusion Chinese Endovascular (BAOCHE) trial and Endovascular Treatment for Acute Basilar‐Artery Occlusion (ATTENTION), and a meta‐analysis of all randomized controlled trials support EVT in patients with moderate to severe basilar artery occlusion stroke symptoms.

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General anesthesia versus conscious sedation during endovascular treatment in posterior circulation large vessel occlusion: A systematic review and meta-analysis

Cited by 4 publications

References 30 publications

Outcomes and risk factors for infection after endovascular treatment in patients with acute ischemic stroke

Outcomes and risk factors for infection after endovascular treatment in patients with acute ischemic stroke

Outcomes with General Anesthesia Compared to Conscious Sedation for Endovascular Treatment of Medium Vessel Occlusions: Results of an International Multicentric Study

Endovascular Treatment in Acute Basilar Artery Occlusion Stroke: A Brief Practice Update From the Society of Vascular and Interventional Neurology

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