Abstract:
BACKGROUND AND PURPOSE:Outcome after mechanical thrombectomy for ischemic stroke may be influenced by blood pressure (BP). This study aims to assess the association of BP changes during general anesthesia versus conscious sedation with functional outcome after mechanical thrombectomy. METHODS:SIESTA (Sedation vs Intubation for Endovascular Stroke Treatment) was a monocentric randomized trial of general anesthesia versus conscious sedation during mechanical thrombectomy involving BP target protocols. In this post hoc analysis, BP measurements were divided into 4 phases: preintervention, prerecanalization, postrecanalization, and postintervention. We examined the association between BP and functional outcomes (defined by improvement of 24-hour National Institutes of Health Stroke Scale [NIHSS] and 3-month modified Rankin Scale). RESULTS:We found no association between the difference in systolic BP, diastolic BP, and mean arterial pressure from baseline to the different phases of intervention and NIHSS change after 24 hours. Only baseline diastolic BP was associated with a reduced improvement in NIHSS (β=0.17, P<0.01). There was no association of BP drops with a change in modified Rankin Scale at 3 months. About sedation, only baseline mean arterial pressure preintervention revealed significant associations (β=0.16, P<0.01) with less change in 24-hour NIHSS in conscious sedation group. Otherwise, there was no association for differences of any of the BP measurements with a change in 24-hour NIHSS and long-term functional outcome either in general anesthesia or the conscious sedation group when analyzed separately, consistent with our findings in the entire cohort. Doses of propofol (β=0.84, P=0.04) and norepinephrine (β=1.87, P=0.01) administered during intervention before recanalization were associated with reduced improvement of NIHSS at 24 hours. CONCLUSIONS:In a setting, where both sedation regimes general anesthesia and conscious sedation were performed according to strict protocols directed at avoiding BP extremes, our findings suggest that peri-interventional BP drops were not associated with either early neurological improvement or long-term functional outcome. CLINICAL TRIAL REGISTRATION:URL: https://www.clinicaltrials.gov. Unique identifier: NCT02126085.
journal_name
Strokejournal_title
Strokeauthors
Schönenberger S,Uhlmann L,Ungerer M,Pfaff J,Nagel S,Klose C,Bendszus M,Wick W,Ringleb PA,Kieser M,Möhlenbruch MA,Bösel Jdoi
10.1161/STROKEAHA.117.019709subject
Has Abstractpub_date
2018-06-01 00:00:00pages
1451-1456issue
6eissn
0039-2499issn
1524-4628pii
STROKEAHA.117.019709journal_volume
49pub_type
杂志文章,随机对照试验相关文献
STROKE文献大全abstract:BACKGROUND AND PURPOSE:Our goal was to compare outcomes of patients with proximal middle cerebral artery occlusions treated with intravenous tissue plasminogen activator (tPA) with those of patients treated with stent-based thrombectomy (SBT). METHODS:Patients with proximal middle cerebral artery occlusions included i...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.112.673665
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Perihematomal edema (PHE) is associated with poor outcomes after intracerebral hemorrhage (ICH). PHE evolves in the early period after ICH, providing a therapeutic target and window for intervention. We studied the effect of PHE volume expansion in the first 72 hours (iPHE) and its relationship w...
journal_title:Stroke
pub_type: 杂志文章,随机对照试验
doi:10.1161/STROKEAHA.115.010054
更新日期:2015-11-01 00:00:00
abstract::Background and Purpose- Endovascular thrombectomy (ET) door-to-puncture time (DTPT) is a modifiable metric. One of the most important, yet time-consuming steps, is documentation of large vessel occlusion by computed tomography angiography (CTA). We hypothesized that obtaining CTA on board a Mobile Stroke Unit and dire...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.119.028626
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:A high incidence of arteriovenous malformations (AVMs) is associated with hereditary hemorrhagic telangiectasia type 1. Endoglin, the gene mutated in this disorder, is expressed at reduced levels on blood vessels of these patients. Since endoglin is a component of the transforming growth factor-b...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.31.11.2653
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The Combined Lysis of Thrombus in Brain Ischemia With Transcranial Ultrasound and Systemic T-PA-Hands-Free (CLOTBUST-HF) study is a first-in-human, National Institutes of Health-sponsored, multicenter, open-label, pilot safety trial of tissue-type plasminogen activator (tPA) plus a novel operator...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.113.002713
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:If it could be determined whether cerebral blood flow can be maintained (autoregulated) during transient falls in arterial blood pressure, we might be able to identify patients with carotid stenosis who are at risk of stroke. However, conventional methods of determining autoregulation in such pat...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.28.7.1340
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The neuroprotective efficacy of an intravenous formulation of the antioxidant ebselen has been comprehensively assessed with specific regard to conventional quantitative histopathology, subcortical axonal damage, neurological deficit, and principal mechanism of action. METHODS:Transient focal is...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/hs0901.095725
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Reduction of cerebral blood flow results in several acute metabolic disturbances, including a reduction in Na,K-ATPase activity. The relation between this reduction and the onset of edema is unknown, as is the effect of restoration of blood flow. Therefore, we investigated the role of decreased N...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.23.9.1331
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Acute cocaine use has been temporally associated with aneurysmal subarachnoid hemorrhage (aSAH). This study analyzes the impact of cocaine use on patient presentation, complications, and outcomes. METHODS:Data of patients admitted with aSAH between 1991 and 2009 were reviewed to determine impact...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.111.000749
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Glutamate receptor antagonists are protective in animal models of focal cerebral ischemia. Lamotrigine (3,5-diamino-6-[2,3-dichlorophenyl]-1,2,4-triazine) is an anticonvulsant drug that blocks voltage-gated sodium channels and inhibits the ischemia-induced release of glutamate. We describe the ce...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.26.1.117
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The limited walking ability that follows a stroke restricts the patient's independent mobility about the home and community, a significant social handicap. To improve the in-hospital prediction of functional outcome, the relationships between impairment, disability, and handicap were assessed wit...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.26.6.982
更新日期:1995-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Antiplatelet therapy is currently one of the methods for preventing transient ischemic attacks and cerebral thrombosis. Because antiplatelet agents are generally administered on a long-term basis, patient compliance is an important factor. The purpose of this study was to determine the compliance...
journal_title:Stroke
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.str.25.12.2337
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Clomethiazole is a neuroprotective drug that enhances gamma-aminobutyrate type A (GABA(A)) receptor activity. Its efficacy and safety were tested in the CLomethiazole Acute Stroke Study (CLASS). The protocol allowed a CT scan to be done after randomization but within 7 days of stroke onset to min...
journal_title:Stroke
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.str.31.1.82
更新日期:2000-01-01 00:00:00
abstract::We studied the pattern and outcome of strokes in 200 Saudi patients. Cerebral infarction constituted 87% of strokes, subarachnoid hemorrhage 4.5%, cerebral hemorrhage 6.5%, and venous infarction 2%. The vessel most commonly involved was part or all of the middle cerebral artery, constituting 52% (90) of the 174 arteri...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.22.9.1173
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Accumulating evidence indicates that a variety of infections contribute to the pathogenesis of atherosclerosis, but there is controversy concerning the impact of Helicobacter pylori infections in atherosclerosis. METHODS:We evaluated seropositivity to H pylori and to its cytotoxin-associated gen...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000058481.82639.EF
更新日期:2003-03-01 00:00:00
abstract::There have been numerous failures in the field of acute stroke therapy over many years, but the first large clinical trial showing preliminary indications of efficacy and safety of a neuroprotective drug, NXY-059, has now been fully reported. If confirmed, it will mean that a second therapy for acute stroke has been i...
journal_title:Stroke
pub_type: 杂志文章,评审
doi:10.1161/01.STR.0000252090.44428.82
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Potassium channels are important regulators of resting tone in large cerebral arteries, but their activity and distribution may vary according to vessel location and species studied. In the cerebral microcirculation in vivo, however, these channels appear to be silent at rest. Our goal was to det...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.32.1.218
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Osteogenic protein-1 (OP1) not only possesses trophic activity on bone tissue but also influences neuronal survival and differentiation in vitro. Specific receptors for OP1 are present in brain and spinal cord and can be upregulated during cerebral contusion. OP1 is a member of the transforming g...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.30.1.126
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:South Asians are the most prevalent ethnic group in the world. Intracranial disease is the most common vascular lesion worldwide. METHODS:We prospectively studied 200 consecutive ethnic South Asian patients with acute ischemic stroke in Singapore. RESULTS:Intracranial large-artery disease was p...
journal_title:Stroke
pub_type: 信件
doi:10.1161/STROKEAHA.107.484584
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:To evaluate the impact of proximal flow control on efficacy and safety of mechanical thrombectomy in an in vitro middle cerebral artery occlusion. METHODS:Three independent variables, including clot type, device (Merci Retriever, Solitaire FR, and Trevo devices), and use of a balloon guide cathe...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.111.670463
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We examined whether hemodynamic and metabolic abnormalities in the cerebral white matter, basal ganglia, and thalamus are associated with asymptomatic white matter lesions (WML) depicted on MR images. METHODS:A positron emission tomographic study with H2(15)O, C15O, and 15O2 was performed in eig...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.28.10.1944
更新日期:1997-10-01 00:00:00
abstract::The value of the concomittant use of a real time frequency analyzer along with a continuous wave carotid Doppler scanner is demonstrated in this study of 118 cases. With a colour-coded Doppler scanner alone, internal carotid stenoses greater than 35% were diagnosed with a sensitivity of 95% and a specificity of 82%. W...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.13.5.660
更新日期:1982-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We studied whether the inducible nitric oxide synthase (iNOS) inhibitor aminoguanidine reduces focal cerebral ischemic damage in a relatively noninvasive stroke model in which the rat middle cerebral artery (MCA) is occluded using an intravascular filament. METHODS:In rats anesthetized with halo...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.27.2.317
更新日期:1996-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Computed tomography is now routinely used in many hospitals to investigate cerebrovascular disease. The purpose of our prospective study was to determine whether cranial computed tomography in connection with neurological assessment was useful in prognostic evaluation of survival after acute stro...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.23.4.506
更新日期:1992-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:There have been very few population-based cohort studies of long-term prognosis and risk factors for death after stroke. We examined the 10-year prognosis, causes, and risk factors of death after stroke in a Japanese cohort. METHODS:During a 26-year follow-up of a cohort of 1621 subjects > or =4...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000091845.14833.43
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We investigated the intra- and interrater reliability of ischemic lesion volumes measurements assessed by different MRI sequences at various times from onset. METHODS:Ischemic lesion volumes were measured for intrarater reliability using diffusion-weighted (DWI), mean transit time (MTT) perfusio...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000249416.77132.1a
更新日期:2006-12-01 00:00:00
abstract::Background and Purpose- The simplified stroke-thrombolytic predictive instrument (s-Stroke-TPI) is useful for predicting the outcomes in thrombolysis-treated patients in Western populations. We aimed to validate its predictive value in Chinese patients. Methods- Data from thrombolysis implementation and monitor of acu...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.118.022269
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:There is expanding literature to show that certain patients admitted during the weekend have worse outcomes than similar patients admitted during the week. Although many clinicians have hypothesized the presence of this "weekend effect" with patients with intracerebral hemorrhage, there is a pauc...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.108.546572
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Many foods have been suggested to influence the risk of stroke. However, no previous studies have examined the relationship between overall dietary patterns and risk of stroke. METHODS:Using dietary information collected in 1984 from 71,768 women aged 38 to 63 years without a history of cardiova...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000135762.89154.92
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Tetrahydrobiopterin (THBP) is an essential cofactor for nitric oxide synthase (NOS), which is responsible for the synthesis of the endothelium-derived relaxing factor (EDRF) responsible for mediating the vasorelaxation produced by acetylcholine (ACh). Previous publications suggest that EDRFACh is...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.28.1.186
更新日期:1997-01-01 00:00:00