Evidence map›Paper›PMID 31072970›Full record

Trial reportAJNR. American journal of neuroradiology2019

Thrombectomy with Conscious Sedation Compared with General Anesthesia: A DEFUSE 3 Analysis.

C J Powers, D Dornbos, M Mlynash, D Gulati, M Torbey, S M Nimjee, M G Lansberg, G W Albers, M P Marks

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in AJNR. American journal of neuroradiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 4 pooled it
5.6field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 4 syntheses or guidelines pooled it, 57 citations in OpenAlex.

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  3. Type of anaesthesia for acute ischaemic stroke endovascular treatment.The Cochrane database of systematic reviews · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

C J PowersFrom the Departments of Neurological Surgery (C.J.P., D.D., S.M.N.) ciaran.powers@osumc.edu.ORCID 0000-0001-7339-0001
D DornbosFrom the Departments of Neurological Surgery (C.J.P., D.D., S.M.N.).ORCID 0000-0002-0039-0016
M MlynashDepartments of Neurology and Neurological Science (M.M., M.G.L., G.W.A.).ORCID 0000-0001-7483-8699
D GulatiNeurology (D.G.), Ohio State University Wexner Medical Center, Columbus, Ohio.ORCID 0000-0003-3374-5992
M TorbeyDepartment of Neurology (M.T.), University of New Mexico, Albuquerque, New Mexico.ORCID 0000-0001-8187-9683
S M NimjeeFrom the Departments of Neurological Surgery (C.J.P., D.D., S.M.N.).ORCID 0000-0002-0317-8731
M G LansbergDepartments of Neurology and Neurological Science (M.M., M.G.L., G.W.A.).ORCID 0000-0002-3545-6927
G W AlbersDepartments of Neurology and Neurological Science (M.M., M.G.L., G.W.A.).ORCID 0000-0003-0263-4632
M P MarksDiagnostic Radiology (M.P.M.), Stanford University School of Medicine, Stanford, California.ORCID 0000-0002-8610-8623
MACOM (United States) · USNeurological Surgery · USStanford Medicine · USThe Ohio State University Wexner Medical Center · USUniversity of New Mexico · US

Funding

DEFUSE 3: EnDovascular ThErapy Following Imaging EvalUation for ISchemic StrokE 3U01NS092076 · NINDS · STANFORD UNIVERSITY · PI ALBERS, GREGORY W · 2015 to 2016
$5.3M
Stanford University Regional Coordinating Stroke Center for the NIH Stroke Trials NetworkU24NS107220 · NINDS · STANFORD UNIVERSITY · PI MAARTEN G LANSBERG · 2018 to 2026
$2.8M
NINDS NIH HHS U01 NS092076NINDS NIH HHS U24 NS107220
6 · The paper itself

Abstract

background and purposeThe optimal patient sedation during mechanical thrombectomy for ischemic stroke in the extended time window is unknown. The purpose of this study was to assess the impact of patient sedation on outcome in patients undergoing thrombectomy 6-16 hours from stroke onset. MATERIALS AND

methodsEndovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3 (DEFUSE 3) was a multicenter, randomized, open-label trial of thrombectomy for ICA and M1 occlusions in patients 6-16 hours from stroke onset. Subjects underwent thrombectomy with either general anesthesia or conscious sedation at the discretion of the treating institution.

resultsOf the 92 patients who were randomized to intervention, 26 (28%) underwent thrombectomy with general anesthesia and 66 (72%) underwent thrombectomy with conscious sedation. Baseline clinical and imaging characteristics were similar among all groups. Functional independence at 90 days was 23% for general anesthesia, 53% for conscious sedation, and 17% for medical management (

conclusionsPatients who underwent thrombectomy with conscious sedation in the extended time window experienced a higher likelihood of functional independence at 90 days, a lower NIHSS score at 24 hours, and a shorter time from femoral puncture to reperfusion compared with those who had general anesthesia. This effect remained robust in institutions that only treated patients with a single anesthesia technique.

Indexed as

AgedAnesthesia, GeneralBrain IschemiaEndovascular ProceduresFemaleHumansMaleMiddle AgedProcedural SedationStrokeThrombectomyTreatment Outcome

Identifiers

PMID31072970
PMCPMC6565453
OpenAlexW2944076915

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.