General anesthesia vs procedural sedation for failed NeuroThrombectomy undergoing rescue stenting: intention to treat analysis.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mohammaden Mahmoud H, Haussen Diogo C, Al-Bayati Alhamza R, Hassan Ameer E, Tekle Wondwossen, Fifi Johanna T, Matsoukas Stavros, Kuybu Okkes, Gross Bradley A, Lang Michael, Narayanan Sandra, Cortez Gustavo M, Hanel Ricardo A, Aghaebrahim Amin, Sauvageau Eric, Farooqui Mudassir, Ortega-Gutierrez Santiago, Zevallos Cynthia B, Galecio-Castillo Milagros, Sheth Sunil A, Nahhas Michael, Salazar-Marioni Sergio, Nguyen Thanh N, Abdalkader Mohamad, Klein Piers, Hafeez Muhammad, Kan Peter, Tanweer Omar, Khaldi Ahmad, Li Hanzhou, Jumaa Mouhammad, Zaidi Syed F, Oliver Marion, Salem Mohamed M, Burkhardt Jan-Karl, Pukenas Bryan, Kumar Rahul, Lai Michael, Siegler James E, Peng Sophia, Alaraj Ali, Nogueira Raul G
Аннотация
METHODS: We searched the data from the Stenting and Angioplasty In Neuro Thrombectomy (SAINT) study. In our review we included patients if they had anterior circulation large vessel occlusion strokes due to intracranial internal carotid artery (ICA) or middle cerebral artery (MCA-M1/M2) segments, failed MT, and underwent rescue ICAS. The cohort was divided into two groups: GA and non-GA. We used propensity score matching to balance the two groups. The primary outcome was the shift in the degree of disability as measured by the modified Rankin Scale (mRS) at 90 days. Secondary outcomes included functional independence (90-day mRS0-2) and successful reperfusion defined as mTICI2B-3. Safety measures included symptomatic intracranial hemorrhage (sICH) and 90-day mortality.
RESULTS: Among 253 patients who underwent rescue ICAS, 156 qualified for the matching analysis at a 1:1 ratio. Baseline demographic and clinical characteristics were balanced between both groups. Non-GA patients had comparable outcomes to GA patients both in terms of the overall degree of disability (mRS ordinal shift; adjusted common odds ratio 1.29, 95% CI [0.69 to 2.43], P=0.43) and rates of functional independence (33.3% vs 28.6%, adjusted odds ratio 1.32, 95% CI [0.51 to 3.41], P=0.56) at 90 days. Likewise, there were no significant differences in rates of successful reperfusion, sICH, procedural complications or 90-day mortality among both groups.
CONCLUSIONS: Non-GA seems to be a safe and effective anesthesia strategy for patients undergoing rescue ICAS after failed MT. Larger prospective studies are warranted for more concrete evidence.