Factors influencing the need for emergent conversion to general anesthesia during mechanical thrombectomy in acute anterior circulation stroke - A retrospective observational study
Copyright © 2023 Elsevier Ltd. All rights reserved..
BACKGROUND: Endovascular mechanical thrombectomy (EMT) for acute ischemic stroke can be conducted under conscious sedation (CS) or general anesthesia (GA). Emergency conversion from CS to GA during the procedure can occur, but its predictors and impact on clinical outcomes are not fully understood.
METHODS: A single centre retrospective analysis was conducted on 226 patients who underwent EMT for anterior circulation stroke. Two groups were identified: patients who completed the procedure under CS and those requiring emergency conversion to GA. The predictors of emergency conversion to GA and its impact on clinical outcomes were analyzed.
RESULTS: Forty-five patients (19.9%) required conversion to GA. Atrial fibrillation (OR 2.38; CI 1.09-5.22; p = 0.03) and prolonged duration of procedure (OR 1.02; CI 1.01-1.04; p < 0.001) were identified as the independent predictors of emergency conversion to GA.
CONCLUSION: Patients with atrial fibrillation and prolonged duration of procedure especially when utilizing combined aspiration-stent retriever or angioplasty/stenting techniques, had a higher likelihood of requiring emergency conversion to general anesthesia (GA).
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:116 |
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| Enthalten in: |
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia - 116(2023) vom: 01. Okt., Seite 20-26 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Byrappa, Vinay [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 20.09.2023 Date Revised 20.09.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jocn.2023.08.007 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM360960936 |
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| 245 | 1 | 0 | |a Factors influencing the need for emergent conversion to general anesthesia during mechanical thrombectomy in acute anterior circulation stroke - A retrospective observational study |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 20.09.2023 | ||
| 500 | |a Date Revised 20.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Endovascular mechanical thrombectomy (EMT) for acute ischemic stroke can be conducted under conscious sedation (CS) or general anesthesia (GA). Emergency conversion from CS to GA during the procedure can occur, but its predictors and impact on clinical outcomes are not fully understood | ||
| 520 | |a METHODS: A single centre retrospective analysis was conducted on 226 patients who underwent EMT for anterior circulation stroke. Two groups were identified: patients who completed the procedure under CS and those requiring emergency conversion to GA. The predictors of emergency conversion to GA and its impact on clinical outcomes were analyzed | ||
| 520 | |a RESULTS: Forty-five patients (19.9%) required conversion to GA. Atrial fibrillation (OR 2.38; CI 1.09-5.22; p = 0.03) and prolonged duration of procedure (OR 1.02; CI 1.01-1.04; p < 0.001) were identified as the independent predictors of emergency conversion to GA | ||
| 520 | |a CONCLUSION: Patients with atrial fibrillation and prolonged duration of procedure especially when utilizing combined aspiration-stent retriever or angioplasty/stenting techniques, had a higher likelihood of requiring emergency conversion to general anesthesia (GA) | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute Ischemic Stroke | |
| 650 | 4 | |a Angioplasty | |
| 650 | 4 | |a Aspiration | |
| 650 | 4 | |a Atrial fibrillation | |
| 650 | 4 | |a Emergency conversion to GA | |
| 650 | 4 | |a Endo vascular mechanical thrombectomy | |
| 650 | 4 | |a General anesthesia | |
| 650 | 4 | |a Sedation | |
| 650 | 4 | |a Stent retrieval | |
| 700 | 1 | |a Manohara, Nitin |e verfasserin |4 aut | |
| 700 | 1 | |a John, Seby |e verfasserin |4 aut | |
| 700 | 1 | |a Lobo, Francisco A |e verfasserin |4 aut | |
| 700 | 1 | |a Lamperti, Massimo |e verfasserin |4 aut | |
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