Cover Image

Sedation mode during endovascular stroke treatment in the posterior circulation: is conscious sedation for eligible patients feasible?

Background and Purpose: To compare safety and efficacy of conscious sedation (CS) vs. general anesthesia (GA) in endovascular stroke treatment (EST) of the posterior circulation (PC).Methods: Retrospective single-center analysis of patients receiving EST for large-vessel occlusion (LVO) in PC betwee...

Full description

Saved in:
Bibliographic Details
Main Authors: Weyland, Charlotte S. (Author) , Chen, Min (Author) , Potreck, Arne (Author) , Jäger, Laura Bettina (Author) , Seker, Fatih (Author) , Schönenberger, Silvia (Author) , Bendszus, Martin (Author) , Möhlenbruch, Markus Alfred (Author)
Format: Article (Journal)
Language:English
Published: 17 September 2021
In: Frontiers in neurology
Year: 2021, Volume: 12, Pages: 1-6
ISSN:1664-2295
DOI:10.3389/fneur.2021.711558
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3389/fneur.2021.711558
Verlag, kostenfrei, Volltext: https://www.frontiersin.org/article/10.3389/fneur.2021.711558
Get full text
Author Notes:Charlotte Sabine Weyland, Min Chen, Arne Potreck, Laura Bettina Jäger, Fatih Seker, Silvia Schönenberger, Martin Bendszus and Markus Möhlenbruch
Description
Summary:Background and Purpose: To compare safety and efficacy of conscious sedation (CS) vs. general anesthesia (GA) in endovascular stroke treatment (EST) of the posterior circulation (PC).Methods: Retrospective single-center analysis of patients receiving EST for large-vessel occlusion (LVO) in PC between January 2015 and November 2020. Exclusion criteria were severe stroke syndromes (NIHSS > 20), decreased level of consciousness, intubation for transport, and second stroke within 3 months of follow-up. The primary endpoint was a favorable clinical outcome 90 days after stroke onset (mRS 0-2 or 3 if pre-stroke mRS 3). Secondary endpoints were the rate of EST failure and procedural complications.Results: Of 111 included patients, 45/111 patients (40.5%) were treated under CS and 60/111 (54.0%) under GA. In 6/111 cases (5.4%), sedation mode was changed from CS to GA during EST. Patients treated under CS showed a lower mRS 90 days after stroke onset [mRS, median (IQR): 2.5 (1-4) CS vs. 3 (2-6) GA, p = 0.036] and a comparable rate of good outcome [good outcome, n (%): 19 (42.2) CS vs. 15 (32.6) GA, p = 0.311]. There was no difference in complication rates during EST (6.7% CS vs. 8.3% GA) or intracranial bleeding in follow-up imaging [n (%): 4 (8.9) CS vs. 7 (11.7) GA), p = 0.705]. The rate of successful target vessel recanalization did not differ (84.4% CS vs. 85.0 % GA).Conclusions: In this retrospective study, EST of the posterior circulation under conscious sedation was for eligible patients comparably safe and effective to patients treated under general anesthesia.
Item Description:Gesehen am 14.10.2021
Physical Description:Online Resource
ISSN:1664-2295
DOI:10.3389/fneur.2021.711558

Similar Items