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Outcomes of Anesthesia Selection in Endovascular Treatment of Acute Ischemic Stroke

Peng, Yuming, MD, PhD*; Wu, Youxuan, MD*; Huo, Xiaochuan, MD, PhD; Wu, Peng, PhD; Zhou, Yang, MD*; Li, Jiaxin, MD*; Liang, Fa, MD*; Liu, Xiaoyuan, MD, PhD*; Pan, Yuesong, PhD; Miao, Zhongrong, MD, PhD; Han, Ruquan, MD, PhD* on behalf of Endovascular Therapy for Acute Ischemic Stroke Trial (EAST) group

Journal of Neurosurgical Anesthesiology: January 2019 - Volume 31 - Issue 1 - p 43–49
doi: 10.1097/ANA.0000000000000500
Clinical Investigations
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Background: The association between anesthesia type and outcomes in patients with acute ischemic stroke undergoing endovascular treatment (EVT) remains a subject of ongoing debate.

Methods: This prospective nonrandomized controlled trial included 149 consecutive patients with acute anterior circulation stroke who underwent EVT. The primary outcome was functional independence assessed by the modified Rankin Scale (mRS) after 3 months.

Results: A total of 105 (70.5%) and 44 (29.5%) patients undergoing EVT who received conscious sedation (CS) and general anesthesia (GA), respectively. The patients who received GA had similar demographics and basic National Institute of Health Stroke Scale scores (17 vs. 16, P>0.05) as the patients who received CS. The recanalization time (304 vs. 311 min, P=0.940) and the recanalization rate (86.4% vs. 84.1%, P=0.170) did not differ between the patients receiving the different types of anesthesia. The National Institute of Health Stroke Scale at 24 hours was lower in the patients who received CS than in those who received GA (β=−2.26, 95% confidence interval, −5.30 to 0.79). The independence (modified Rankin Scale score 0 to 2) at 3 months was equal between patients who received GA and those who received CS (odds ratio=0.73, 95% confidence interval, 0.32-1.68). The mortality and the morbidity rates did not differ.

Conclusions: The data indicated that the selection of GA or CS during EVT had no impact on the independent outcomes of patients with anterior circulation occlusion.

Departments of *Anesthesiology

Interventional Neurology

Neurology, Tiantan Clinical Trial and Research Center for Stroke, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR China

Z.M. and R.H. contributed equally.

Y.P., Z.M., and R.H.: helped with the study design and manuscript preparation. Y.W., J.L., and F.L.: helped with the data collection and manuscript preparation. X.H. helped with the patient recruitment. X.L. and Y.Z.: helped with the data collection. P.W. and Y.P.: helped with the data analyses.

Clinical Trial Registration: www.clinicaltrials.gov (NCT02350283).

The trial was funded by the ‘Youth Program’ (QML20150508) and Hospitals Clinical Medicine Development of Special Funding Support (ZYLX201708) from the Beijing Municipal Administration of Hospitals and programs from National Science and Technology Major Project of China (2011BAI08B02, 2015BAI12B04, and 2015BAI12B02).

The authors have no conflicts of interest to disclose.

Address correspondence to: Ruquan Han, MD, PhD, Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, No. 6, Tiantan Xili, Dongcheng District, Beijing 100050, PR China (e-mail: ruquan.han@gmail.com).

Received November 28, 2017

Accepted March 12, 2018

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