Conscious Sedation Versus General Anesthesia During Endovascular Therapy for Acute Anterior Circulation Stroke Preliminary Results From a Retrospective, Multicenter Study
Alex Abou-Chebl,Ridwan Lin,Muhammad S Hussain,Tudor G Jovin,Elad I. Levy,David S Liebeskind,Albert J Yoo,Daniel P Hsu,Marilyn M. Rymer,Ashis H Tayal,Osama O. Zaidat,Sabareesh K. Natarajan,Raul G. Nogueira,Ashish Nanda,Melissa Tian,Qing Hao,Junaid S. Kalia,Thanh N. Nguyen,Michael Chen,Rishi Gupta,Rishi Gupta +20 more
TLDR
Patients placed under GA during IAT for anterior circulation stroke appear to have a higher chance of poor neurologic outcome and mortality and future clinical trials with IAT can help elucidate the etiology of the differences in outcomes.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 2009. Only patients with anterior circulation strokes due to large-vessel occlusion were included in the study. A binary logistic-regression model was used to determine independent predictors of good outcome and death. Results— The mean age was 66±15 years and median National Institutes of Health Stroke Scale score was 17 (interquartile range, 13–20). The overall recanalization rate was 68% and the symptomatic hemorrhage rate was 9.2%. GA was used in 44% of patients with no differences in intracrani...read more
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Journal ArticleDOI
Endovascular Therapy after Intravenous t-PA versus t-PA Alone for Stroke
Joseph P. Broderick,Yuko Y. Palesch,Andrew M. Demchuk,Sharon D. Yeatts,Pooja Khatri,Michael D. Hill,Edward C. Jauch,Tudor G Jovin,Bernard Yan,Frank L. Silver,Ruediger von Kummer,Carlos A. Molina,Bart M. Demaerschalk,Ronald F. Budzik,Wayne M. Clark,Osama O. Zaidat,Tim W. Malisch,Mayank Goyal,Wouter J. Schonewille,Mikael Mazighi,Stefan T. Engelter,Craig S. Anderson,Judith Spilker,Janice Carrozzella,Karla J Ryckborst,L. Scott Janis,Renee H Martin,Lydia D. Foster,Thomas A. Tomsick +28 more
TL;DR: The trial showed similar safety outcomes and no significant difference in functional independence with endovascular therapy after intravenous t-PA, as compared with intravenoust-PA alone.
Journal ArticleDOI
Effect of Conscious Sedation vs General Anesthesia on Early Neurological Improvement Among Patients With Ischemic Stroke Undergoing Endovascular Thrombectomy: A Randomized Clinical Trial
Silvia Schönenberger,Lorenz Uhlmann,Werner Hacke,Simon Schieber,Sibu Mundiyanapurath,Jan C. Purrucker,Simon Nagel,Christina Klose,Johannes Pfaff,Martin Bendszus,Peter A. Ringleb,Meinhard Kieser,Markus A Möhlenbruch,Julian Bösel +13 more
TL;DR: The study findings do not support an advantage for the use of conscious sedation for early neurological improvement among patients receiving stroke thrombectomy among patients with acute ischemic stroke in the anterior circulation.
Journal ArticleDOI
Mechanical thrombectomy in acute ischemic stroke: Consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN:
Nils Wahlgren,Tiago Moreira,Patrik Michel,Thorsten Steiner,Olav Jansen,Christophe Cognard,Heinrich Mattle,Wim H. van Zwam,Staffan Holmin,Turgut Tatlisumak,Jesper Petersson,Valeria Caso,Werner Hacke,Mikael Mazighi,Marcel Arnold,Urs Fischer,István Szikora,Laurent Pierot,Jens Fiehler,Jan Gralla,Franz Fazekas,Kennedy R. Lees +21 more
TL;DR: The original version of this consensus statement on mechanical thrombectomy was approved at the European Stroke Organisation-Karolinska Stroke Update conference in Stockholm, 16–18 November 2014 and has later, during 2015, been updated with new clinical trials data in accordance with a decision made at the conference.
Journal ArticleDOI
General Anesthesia Versus Conscious Sedation for Endovascular Treatment of Acute Ischemic Stroke: The AnStroke Trial (Anesthesia During Stroke).
Pia Löwhagen Hendén,Alexandros Rentzos,Jan-Erik Karlsson,Lars Rosengren,Birgitta Leiram,Henrik Sundeman,Dennis Dunker,Kunigunde Schnabel,Gunnar Wikholm,Mikael Hellström,Sven-Erik Ricksten +10 more
TL;DR: In endovascular treatment for acute ischemic stroke, no difference was found between general anesthesia and conscious sedation in neurological outcome 3 months after stroke.
Journal ArticleDOI
Initial clinical experience with the ADAPT technique: a direct aspiration first pass technique for stroke thrombectomy
Aquilla S Turk,Alex Spiotta,Don Frei,J Mocco,Blaise Baxter,David Fiorella,Adnan H. Siddiqui,Maxim Mokin,Michael C. Dewan,Henry H. Woo,Raymond D Turner,Harris Hawk,Amrendra Miranpuri,Imran Chaudry +13 more
TL;DR: The ADAPT technique is a simple and effective approach to acute ischemic stroke thrombectomy and Utilizing the latest generation of large bore aspiration catheters in this fashion has allowed us to achieve excellent clinical and angiographic outcomes.
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Endovascular Therapy after Intravenous t-PA versus t-PA Alone for Stroke
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