Effect of General Anesthesia Versus Conscious Sedation/Local Anesthesia on the Outcome of Patients with Minor Stroke and Isolated M2 Occlusion Undergoing Immediate Thrombectomy: A Retrospective Multicenter Matched Analysis

被引：5

作者：

Valente, Iacopo ^{[1
]}

Alexandre, Andrea M. ^{[1
]}

Colo, Francesca

Brunetti, Valerio ^{[3
]}

Frisullo, Giovanni ^{[3
]}

Camilli, Arianna ^{[2
]}

Falcou, Anne ^{[4
]}

Scarcia, Luca ^{[5
]}

Gigli, Riccardo ^{[2
]}

Scala, Irene ^{[2
]}

Rizzo, Pier A. ^{[2
]}

Abruzzese, Serena ^{[2
]}

Milonia, Luca ^{[6
]}

Piano, Mariangela ^{[7
]}

Macera, Antonio ^{[7
,11
]}

Ruggiero, Maria ^{[8
,11
]}

Da Ros, Valerio ^{[9
]}

Bellini, Luigi ^{[9
]}

Lazzarotti, Guido A. ^{[10
]}

Cosottini, Mirco ^{[10
]}

Caragliano, Antonio A.

Vinci, Sergio L.

Gabrieli, Joseph D. ^{[12
]}

Causin, Francesco ^{[12
]}

Panni, Pietro ^{[13
]}

Roveri, Luisa ^{[14
]}

Limbucci, Nicola ^{[15
]}

Arba, Francesco ^{[16
]}

Renieri, Leonardo ^{[15
]}

Ferretti, Simone ^{[17
]}

Pileggi, Marco ^{[18
,19
]}

Bianco, Giovanni ^{[19
]}

Romano, Daniele G. ^{[20
]}

Frauenfelder, Giulia ^{[20
]}

Semeraro, Vittorio ^{[21
,22
]}

Ganimede, Maria P. ^{[22
]}

Lozupone, Emilio ^{[23
,24
]}

Fasano, Antonio ^{[24
]}

Lafe, Elvis ^{[25
]}

Cavallini, Anna M.

Mazzacane, Federico ^{[26
]}

Russo, Riccardo ^{[27
]}

Bergui, Mauro ^{[27
]}

Broccolini, Aldobrando ^{[2
,3
]}

Pedicelli, Alessandro ^{[1
,2
]}

机构：

[1] Fdn Policlin Univ A Gemelli IRCCS, Intervent Neuroradiol Unit, Rome, Italy

[2] Catholic Univ, Sch Med, Dept Neurosci, Rome, Italy

[3] Fdn Policlin Univ A Gemelli IRCCS, Neurol Unit, Rome, Italy

[4] Univ Hosp Policlin Umberto I, Stroke Unit, Rome, Italy

[5] Henri Mondor Hosp, Neuroradiol Unit, Creteil, France

[6] Univ Hosp Policlin Umberto I, Intervent Neuroradiol Unit, Rome, Italy

[7] ASST Grande Osped Metropolitano Niguarda, Neuroradiol Unit, Milan, Italy

[8] AUSL Romagna, Neuroradiol Unit, Cesena, Italy

[9] Univ Hosp Rome Tor Vergata, Dept Biomed & Prevent, Rome, Italy

[10] Azienda Osped Univ Pisana AOUP, Neuroradiol Unit, Pisa, Italy

[11] AOU Policlin G Martino, Neuroradiol Unit, Messina, Italy

[12] Univ Padua Polyclin, Neuroradiol Unit, Padua, Italy

[13] IRCCS San Raffaele Univ Hosp, Intervent Neuroradiol Unit, Milan, Italy

[14] IRCCS San Raffaele Univ Hosp, Neurol Unit, Milan, Italy

[15] Intervent Neurovasc Unit, Stroke Unit, AOU Careggi, Florence, Italy

[16] AOU Careggi, Stroke Unit, Florence, Italy

[17] Univ Florence, NEUROFARBA Dept, Florence, Italy

[18] Neuroctr Southern Switzerland EOC, Neuroradiol Unit, Lugano, Switzerland

[19] Neuroctr Southern Switzerland EOC, Stroke Ctr, Lugano, Switzerland

[20] AOU S Giovanni Dio & Ruggi Aragona, Neuroradiol Unit, Salerno, Italy

[21] SS Annunziata Hosp, Intervent Radiol Unit, Taranto, Italy

[22] SS Annunziata Hosp, Neuroradiol Unit, Taranto, Italy

[23] Vito Fazzi Hosp, Neuroradiol Unit, Lecce, Italy

[24] Vito Fazzi Hosp, Neurol Unit, Lecce, Italy

[25] IRCCS Policlin San Matteo, Neuroradiol Unit, Pavia, Italy

[26] IRCCS Fdn Mondino, Cerebrovasc Dis Unit, Pavia, Italy

[27] Azienda Osped Citta Salute & Sci, Neuroradiol Unit, Turin, Italy

来源：

WORLD NEUROSURGERY | 2024年 / 183卷

关键词：

Key; Anesthesia; M2; occlusion; Mechanical thrombectomy; Minor stroke; ACUTE ISCHEMIC-STROKE; ENDOVASCULAR THROMBECTOMY; PROCEDURAL SEDATION; THERAPY; METAANALYSIS; MANAGEMENT; INFARCT; SCORE; CARE;

D O I：

10.1016/j.wneu.2023.12.117

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

- BACKGROUND: This study investigates the impact of general anesthesia (GA) versus conscious sedation/local anesthesia (CS/LA) on the outcome of patients with minor stroke and isolated M2 occlusion undergoing immediate mechanical thrombectomy (iMT). - METHODS: The databases of 16 comprehensive stroke centers were retrospectively screened for consecutive patients with isolated M2 occlusion and a baseline National Institutes of Health Stroke Scale score 5 pound who received iMT. Propensity score matching was used to estimate the effect of GA versus CS/LA on clinical outcomes and procedure -related adverse events. The primary outcome measure was a 90 -day modified Rankin Scale (mRS) score of 0-1. Secondary outcome measures were a 90 -day mRS score of 0-2 and allcause mortality, successful reperfusion, procedural -related symptomatic subarachnoid hemorrhage, intraprocedural dissections, and new territory embolism. - RESULTS: Of the 172 patients who were selected, 55 received GA and 117 CS/LA. After propensity score matching, 47 pairs of patients were available for analysis. We found no significant differences in clinical outcome, rates of efficient reperfusion, and procedural -related complications between patients receiving GA or LA/CS (mRS score 0-1, P = 0.815; mRS score 0-2, P = 0.401; all cause mortality, P = 0.408; modified Treatment in Cerebral Infarction score 2b - 3, P = 0.374; symptomatic subarachnoid hemorrhage, P = 0.082; intraprocedural dissection, P = 0.408; new territory embolism, P = 0.462). - CONCLUSIONS: In patients with minor stroke and isolated M2 occlusion undergoing iMT, the type of anesthesia does not affect clinical outcome or the rate of proceduralrelated complications. Our results agree with recent data showing no benefit of one specific anesthesiologic procedure over the other and confirm their generalizability also to patients with minor baseline symptoms.

引用

页码：E432 / E439

页数：8

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