Anesthetic Management and Outcomes of Endovascular Treatment of Basilar Artery Occlusion: Results From the ATTENTION Registry
Background and Purpose To examine the clinical and safety outcomes after endovascular treatment (EVT) for acute basilar artery occlusion (BAO) with different anesthetic modalities. Methods This was a retrospective analysis using data from the Endovascular Treatment for Acute Basilar Artery Occlusion...
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| Format: | Article |
| Language: | English |
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Korean Stroke Society
2023-09-01
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| Series: | Journal of Stroke |
| Subjects: | |
| Online Access: | http://www.j-stroke.org/upload/pdf/jos-2023-00318.pdf |
| _version_ | 1827787181685473280 |
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| author | Chunrong Tao Guangxiong Yuan Pengfei Xu Hao Wang Peiyang Zhou Tingyu Yi Kai Li Tao Cui Jun Gao Rui Li Jun Sun Chao Zhang Li Wang Tianlong Liu Jianlong Song Yamei Yin Thanh N. Nguyen Qing Li Wei Hu |
| author_facet | Chunrong Tao Guangxiong Yuan Pengfei Xu Hao Wang Peiyang Zhou Tingyu Yi Kai Li Tao Cui Jun Gao Rui Li Jun Sun Chao Zhang Li Wang Tianlong Liu Jianlong Song Yamei Yin Thanh N. Nguyen Qing Li Wei Hu |
| author_sort | Chunrong Tao |
| collection | DOAJ |
| description | Background and Purpose To examine the clinical and safety outcomes after endovascular treatment (EVT) for acute basilar artery occlusion (BAO) with different anesthetic modalities. Methods This was a retrospective analysis using data from the Endovascular Treatment for Acute Basilar Artery Occlusion (ATTENTION) registry. Patients were divided into two groups defined by anesthetic modality performed during EVT: general anesthesia (GA) or non-general anesthesia (non-GA). The association between anesthetic management and clinical outcomes was evaluated in a propensity score matched (PSM) cohort and an inverse probability of treatment weighting (IPTW) cohort to adjust for imbalances between the two groups. Results Our analytic sample included 1,672 patients from 48 centers. The anesthetic modality was GA in 769 (46.0%) and non-GA in 903 (54.0%) patients. In our primary analysis with the PSM-based cohort, non-GA was comparable to GA concerning the primary outcome (adjusted common odds ratio [acOR], 1.01; 95% confidence interval [CI], 0.82 to 1.25; P=0.91). Mortality at 90 days was 38.4% in the GA group and 35.8% in the non-GA group (adjusted risk ratio, 0.95; 95% CI, 0.83 to 1.08; P=0.44). In our secondary analysis with the IPTW-based cohort, the anesthetic modality was significantly associated with the distribution of modified Rankin Scale at 90 days (acOR: 1.45 [95% CI: 1.20 to 1.75]). Conclusion In this nationally-representative observational study, acute ischemic stroke patients due to BAO undergoing EVT without GA had similar clinical and safety outcomes compared with patients treated with GA. These findings provide the basis for large-scale randomized controlled trials to test whether anesthetic management provides meaningful clinical effects for patients undergoing EVT. |
| first_indexed | 2024-03-11T16:45:49Z |
| format | Article |
| id | doaj.art-f4453182c9bf42eeb0a1504a408b303a |
| institution | Directory Open Access Journal |
| issn | 2287-6391 2287-6405 |
| language | English |
| last_indexed | 2024-03-11T16:45:49Z |
| publishDate | 2023-09-01 |
| publisher | Korean Stroke Society |
| record_format | Article |
| series | Journal of Stroke |
| spelling | doaj.art-f4453182c9bf42eeb0a1504a408b303a2023-10-23T00:18:04ZengKorean Stroke SocietyJournal of Stroke2287-63912287-64052023-09-0125339940810.5853/jos.2023.00318494Anesthetic Management and Outcomes of Endovascular Treatment of Basilar Artery Occlusion: Results From the ATTENTION RegistryChunrong Tao0Guangxiong Yuan1Pengfei Xu2Hao Wang3Peiyang Zhou4Tingyu Yi5Kai Li6Tao Cui7Jun Gao8Rui Li9Jun Sun10Chao Zhang11Li Wang12Tianlong Liu13Jianlong Song14Yamei Yin15Thanh N. Nguyen16Qing Li17Wei Hu18 Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China Department of Emergency, Xiangtan Central Hospital, Xiangtan, China Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China Department of Neurology, Linyi People’s Hospital, Linyi, China Department of Neurology, Xiangyang No.1 People’s Hospital, Hubei University of Medicine, Xiangyang, China Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China Department of Neurology, Heze Municipal Hospital, Heze, Shandong, China Department of Neurology, Taihe County People’s Hospital, Fuyang, China Department of Neurology, Nanyang Central Hospital, Nanyang, China Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA Department of Laboratory Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, ChinaBackground and Purpose To examine the clinical and safety outcomes after endovascular treatment (EVT) for acute basilar artery occlusion (BAO) with different anesthetic modalities. Methods This was a retrospective analysis using data from the Endovascular Treatment for Acute Basilar Artery Occlusion (ATTENTION) registry. Patients were divided into two groups defined by anesthetic modality performed during EVT: general anesthesia (GA) or non-general anesthesia (non-GA). The association between anesthetic management and clinical outcomes was evaluated in a propensity score matched (PSM) cohort and an inverse probability of treatment weighting (IPTW) cohort to adjust for imbalances between the two groups. Results Our analytic sample included 1,672 patients from 48 centers. The anesthetic modality was GA in 769 (46.0%) and non-GA in 903 (54.0%) patients. In our primary analysis with the PSM-based cohort, non-GA was comparable to GA concerning the primary outcome (adjusted common odds ratio [acOR], 1.01; 95% confidence interval [CI], 0.82 to 1.25; P=0.91). Mortality at 90 days was 38.4% in the GA group and 35.8% in the non-GA group (adjusted risk ratio, 0.95; 95% CI, 0.83 to 1.08; P=0.44). In our secondary analysis with the IPTW-based cohort, the anesthetic modality was significantly associated with the distribution of modified Rankin Scale at 90 days (acOR: 1.45 [95% CI: 1.20 to 1.75]). Conclusion In this nationally-representative observational study, acute ischemic stroke patients due to BAO undergoing EVT without GA had similar clinical and safety outcomes compared with patients treated with GA. These findings provide the basis for large-scale randomized controlled trials to test whether anesthetic management provides meaningful clinical effects for patients undergoing EVT.http://www.j-stroke.org/upload/pdf/jos-2023-00318.pdfstrokeendovascular treatmentbasilar artery occlusionanesthetic management |
| spellingShingle | Chunrong Tao Guangxiong Yuan Pengfei Xu Hao Wang Peiyang Zhou Tingyu Yi Kai Li Tao Cui Jun Gao Rui Li Jun Sun Chao Zhang Li Wang Tianlong Liu Jianlong Song Yamei Yin Thanh N. Nguyen Qing Li Wei Hu Anesthetic Management and Outcomes of Endovascular Treatment of Basilar Artery Occlusion: Results From the ATTENTION Registry Journal of Stroke stroke endovascular treatment basilar artery occlusion anesthetic management |
| title | Anesthetic Management and Outcomes of Endovascular Treatment of Basilar Artery Occlusion: Results From the ATTENTION Registry |
| title_full | Anesthetic Management and Outcomes of Endovascular Treatment of Basilar Artery Occlusion: Results From the ATTENTION Registry |
| title_fullStr | Anesthetic Management and Outcomes of Endovascular Treatment of Basilar Artery Occlusion: Results From the ATTENTION Registry |
| title_full_unstemmed | Anesthetic Management and Outcomes of Endovascular Treatment of Basilar Artery Occlusion: Results From the ATTENTION Registry |
| title_short | Anesthetic Management and Outcomes of Endovascular Treatment of Basilar Artery Occlusion: Results From the ATTENTION Registry |
| title_sort | anesthetic management and outcomes of endovascular treatment of basilar artery occlusion results from the attention registry |
| topic | stroke endovascular treatment basilar artery occlusion anesthetic management |
| url | http://www.j-stroke.org/upload/pdf/jos-2023-00318.pdf |
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