Abstract:
BACKGROUND AND PURPOSE:The impact of anesthesia technique on the outcomes of mechanical thrombectomy for acute ischemic stroke remains an issue of debate. We investigated the association of general anesthesia with outcomes in patients undergoing mechanical thrombectomy for ischemic stroke. METHODS:We performed a cohort study involving patients undergoing mechanical thrombectomy for ischemic stroke from 2009 to 2013, who were registered in the New York Statewide Planning and Research Cooperative System database. An instrumental variable (hospital rate of general anesthesia) analysis was used to simulate the effects of randomization and investigate the association of anesthesia technique with case-fatality and length of stay. RESULTS:Among 1174 patients, 441 (37.6%) underwent general anesthesia and 733 (62.4%) underwent conscious sedation. Using an instrumental variable analysis, we identified that general anesthesia was associated with a 6.4% increased case-fatality (95% confidence interval, 1.9%-11.0%) and 8.4 days longer length of stay (95% confidence interval, 2.9-14.0) in comparison to conscious sedation. This corresponded to 15 patients needing to be treated with conscious sedation to prevent 1 death. Our results were robust in sensitivity analysis with mixed effects regression and propensity score-adjusted regression models. CONCLUSIONS:Using a comprehensive all-payer cohort of acute ischemic stroke patients undergoing mechanical thrombectomy in New York State, we identified an association of general anesthesia with increased case-fatality and length of stay. These considerations should be taken into account when standardizing acute stroke care.
journal_name
Strokejournal_title
Strokeauthors
Bekelis K,Missios S,MacKenzie TA,Tjoumakaris S,Jabbour Pdoi
10.1161/STROKEAHA.116.015343subject
Has Abstractpub_date
2017-02-01 00:00:00pages
361-366issue
2eissn
0039-2499issn
1524-4628pii
STROKEAHA.116.015343journal_volume
48pub_type
杂志文章相关文献
STROKE文献大全abstract:BACKGROUND AND PURPOSE:Some strokes of unknown etiology may be the result of a paradoxical embolism traversing through a nonfused foramen ovale (patent foramen ovale [PFO]). The utility of percutaneously placed devices for treatment of patients with cryptogenic stroke or transient ischemic attack (TIA) and PFO is unkno...
journal_title:Stroke
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/STROKEAHA.110.593376
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Although the short-term risks of stroke and types of stroke associated with isolated systolic hypertension (ISH) and borderline isolated systolic hypertension (BISH) have been described, the long-term effects of these hypertensive conditions, particularly in younger individuals, are unclear. We p...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.0000039402.05613.0f
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The impact of asymptomatic coronary artery disease on the risk of major vascular events in patients with cerebral infarction is unknown. METHODS:Four hundred five patients with acute cerebral infarction underwent carotid, femoral artery, thoracic, and abdominal aorta ultrasound examination. Of 3...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.111.000142
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We sought to evaluate how accurately length and volume of thrombotic clots occluding cerebral arteries of patients with acute ischemic stroke can be assessed from nonenhanced CT (NECT) scans reconstructed with different slice widths. METHODS:NECT image data of 58 patients with acute ischemic str...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.110.580662
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Three-dimensional pseudocontinuous arterial spin labeling with multiple postlabeling delays has been used to assess cerebral blood flow (CBF). We used this modality to estimate antegrade and collateral flow in patients with unilateral middle cerebral artery stenosis. METHODS:Consecutive patients...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.115.011057
更新日期:2016-02-01 00:00:00
abstract::Feline pial arteries larger than 100 mu in diameter constricted in response to cervical sympathetic nerve stimulation suggests or in response to topical application of norepinephrine. Smaller pial arteries were unresponsive to norepinephrine. This unresponsiveness persisted when norepinephrine was dissolved in CSF wit...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.6.6.654
更新日期:1975-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The absence of a widely available and sensitive diagnostic test for acute cerebral ischemia remains a significant limitation in the diagnosis and management of stroke. The objective of this study was to examine the feasibility of developing a diagnostic panel of blood-borne biochemical markers of...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000105927.62344.4C
更新日期:2004-01-01 00:00:00
abstract::We devised the present experiments to assess the effects of ischemia on the production of dopamine in the caudate nucleus of spontaneously hypertensive stroke-resistant rats. Ringer's solution was continuously perfused at a rate of 10 microliters/min through 0.2-mm-diameter dialysis tubing implanted in the rat's cauda...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.19.12.1540
更新日期:1988-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Endothelins (ETs) are potent vasoconstrictors and may play a role in the pathophysiology of several diseases. Limited and controversial data exist on their role in human ischemic stroke. We planned a prospective, observational, and longitudinal clinical study to test whether ET-1 levels increase ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.31.3.720
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:It has been suggested that the interleukin-1A (IL-1A) allele 2 is a risk factor for Alzheimer's disease (AD). Because cerebral amyloid angiopathy-related hemorrhage (CAAH) often coexists with AD, we examined the IL-1A polymorphism in CAAH. METHODS:In a case-control study, patients with pathologi...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000089294.85447.1E
更新日期:2003-10-01 00:00:00
abstract::In the rat an intracisternal injection of blood induces an angiographically demonstrable biphasic cerebral arterial vasospasm. Chemical destruction of the central serotoninergic and dopaminergic pathways prior to the cisternal blood injection does not affect the spasm pattern after the subarachnoid haemorrhage. It is ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.17.1.86
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The use of percutaneous transluminal coronary angioplasty (PTCA) to treat coronary artery disease is now commonplace. The occurrence of microemboli during invasive procedures such as cardiac angiography and bypass surgery is well documented, although neurological complications are relatively unco...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.29.11.2367
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Determination of vasomotor reserve (VMR) with the transcranial Doppler-CO(2) (TCD-CO(2)) test is used to assess the risk of impending cerebral ischemia in patients with high-grade stenosis or occlusion of the internal carotid artery. In patients with a poor temporal window, however, this examinat...
journal_title:Stroke
pub_type: 临床试验,杂志文章
doi:10.1161/01.str.32.6.1298
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We designed a prospective sequential pretreatment and posttreatment MRI study to assess the relation between neuroimaging parameters and clinical outcome in patients treated with intravenous recombinant tissue-type plasminogen activator (rtPA). METHODS:Patients with symptoms of acute hemispheric...
journal_title:Stroke
pub_type: 临床试验,杂志文章
doi:10.1161/01.str.0000053850.64877.af
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:The method described provides a rational means for determining whether to institute chronic anticoagulation to prevent stroke in patients with chronic atrial fibrillation under a variety of clinical circumstances. SUMMARY OF COMMENT:The concept of expected value is used in conjunction with data from clinica...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.24.12.2128
更新日期:1993-12-01 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:BACKGROUND AND PURPOSE:The aim of this investigation was to compare the respective efficacy of transcranial Doppler sonography (TCD) and magnetic resonance angiography (MRA) for the assessment of intracranial hemodynamics in patients with extracranial occlusion or severe stenosis of the internal carotid artery (ICA). ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.26.2.214
更新日期:1995-02-01 00:00:00
abstract::The intact omentum of 13 monkeys was lengthened, placed subcutaneously, and laid on the left cerebral hemisphere prior to occluding the left middle cerebral artery. Two of these 13 monkeys developed left cerebral infarct and a right hemiparesis. Nine other monkeys had their left middle cerebral artery occluded without...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.9.3.224
更新日期:1978-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Elevated cardiac troponin is a marker of cardiac disease and has been recently shown to be associated with embolic stroke risk. We hypothesize that early elevated troponin levels in the acute stroke setting are more prevalent in patients with embolic stroke subtypes (cardioembolic and embolic str...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.117.019395
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The aim of this study was to assess the costs and cost-effectiveness of intravenous thrombolysis treatment with alteplase (Actilyse) of acute ischemic stroke with 24-hour in-house neurology coverage and use of magnetic resonance imaging. METHODS:A health economic model was designed to calculate ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000251790.19419.a8
更新日期:2007-01-01 00:00:00
abstract::The external diameters of rat and rabbit basilar arteries were determined before and after formaldehyde fixation in relaxed and drug constricted vessels. Fixation usually resulted in an immediate vessel constriction followed by partial relaxation after several hours. However, the results were inconstant from vessel to...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.11.1.99
更新日期:1980-01-01 00:00:00
abstract::We mapped average age-adjusted stroke mortality rates for white men and white women aged 35-74 years for state economic areas (counties or groups of counties) in the continental United States for three 7-year periods between 1962 and 1982. Despite the decline of national stroke mortality rates, rates in some areas fai...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.19.12.1507
更新日期:1988-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Carotid artery stenting (CAS) is an alternative to carotid endarterectomy (CEA) for stroke prevention. The value of this therapy relative to CEA remains uncertain. METHODS:In 10 958 Medicare patients aged 66 years or older between 2004 and 2006, we analyzed in-hospital, 1-year stroke, myocardial...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.110.608992
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Experimental and clinical data suggest that insonation of echo-contrast agents with high acoustical power produces disintegration of microbubbles, resulting in a pseudo-Doppler phenomenon called stimulated acoustic emission (SAE). The purpose of this study was to investigate whether SAE might be ...
journal_title:Stroke
pub_type: 临床试验,杂志文章
doi:10.1161/01.str.31.7.1661
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Endovascular treatment of carotid stenosis may be an alternative to surgical endarterectomy. We conducted a systematic review of the randomized evidence to assess the benefits and risks of endovascular treatment compared to surgery. METHODS:Cochrane registers and online databases were searched a...
journal_title:Stroke
pub_type: 杂志文章,评审
doi:10.1161/STROKEAHA.108.531228
更新日期:2009-04-01 00:00:00
abstract::We tested the hypothesis that hypertension is more common and cardiac embolism less common in patients with lacunar infarction than in patients with other types of cerebral infarction. We studied risk factor profiles in a series of 102 consecutive patients with a lacunar infarct and 202 consecutive patients with a car...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.21.3.375
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Lower birth weight is associated with increased risk of stroke, but little is known about the mechanism for this association or influence in addition to vascular risk factors. We investigated whether there was an association between birth parameters and imaging markers of white matter integrity i...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.108.527259
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Elevated soluble CD40 ligand (sCD40L) was shown to be related to cardiovascular events, but the role of sCD40L in predicting recurrent stroke remains unclear. METHODS:Baseline sCD40L levels were measured in 3044 consecutive patients with acute minor stroke and transient ischemic attack, who had ...
journal_title:Stroke
pub_type: 杂志文章,随机对照试验
doi:10.1161/STROKEAHA.115.008685
更新日期:2015-07-01 00:00:00
abstract::Leukoaraiosis is a common finding in stroke patients and has been strongly associated with risk of incident stroke and dementia. Leukoaraiosis may also be an independent predictor of stroke outcomes. There is increasing evidence from neuroimaging to support the concept that some leukoaraiosis is caused by white matter...
journal_title:Stroke
pub_type: 杂志文章,评审
doi:10.1161/STROKEAHA.110.596056
更新日期:2010-10-01 00:00:00
abstract::In a postasphyxia neonatal lamb model, the responses of the cerebral circulation to hypoxic hypoxia and changes in systemic arterial blood pressure were examined. Ventilated newborn lambs (n = 14) were subjected to a gradual asphyxial insult, resuscitated, and returned to control ventilator settings. During the time 2...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.19.2.239
更新日期:1988-02-01 00:00:00