Sedation mode during endovascular stroke treatment in the posterior circulation

• Verfasst von: Weyland, Charlotte S. [VerfasserIn]
• Verfasst von: Chen, Min [VerfasserIn]
• Verfasst von: Potreck, Arne [VerfasserIn]
• Verfasst von: Jäger, Laura Bettina [VerfasserIn]
• Verfasst von: Seker, Fatih [VerfasserIn]
• Verfasst von: Schönenberger, Silvia [VerfasserIn]
• Verfasst von: Bendszus, Martin [VerfasserIn]
• Verfasst von: Möhlenbruch, Markus Alfred [VerfasserIn]
• Titel: Sedation mode during endovascular stroke treatment in the posterior circulation
• Titelzusatz: is conscious sedation for eligible patients feasible?
• Verf.angabe: Charlotte Sabine Weyland, Min Chen, Arne Potreck, Laura Bettina Jäger, Fatih Seker, Silvia Schönenberger, Martin Bendszus and Markus Möhlenbruch
• E-Jahr: 2021
• Jahr: 17 September 2021
• Umfang: 6 S.
• Teil: volume:12
• Teil: year:2021
• Teil: day:17
• Teil: month:09
• Teil: elocationid:711558
• Teil: pages:1-6
• Teil: extent:6
• Fussnoten: Gesehen am 14.10.2021
• Titel Quelle: Enthalten in: Frontiers in neurology
• Ort Quelle: Lausanne : Frontiers Research Foundation, 2008
• Jahr Quelle: 2021
• Band/Heft Quelle: 12(2021) vom: 17. Sept., Artikel-ID 711558, Seite 1-6
• ISSN Quelle: 1664-2295
• DOI: doi:10.3389/fneur.2021.711558
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1773839551
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

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.