Evidence map›Paper›PMID 36464668›Full record

ArticleInterventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences2024

The effect of procedural end-tidal CO2 on infarct expansion during anterior circulation thrombectomy.

Matthew S Parr, Arsalaan Salehani, Mark Ogilvie, B Ethan Tabibian, Sage Rahm, Andrew T Hale, Georges Bouobda Tsemo, Akshay Aluri, Jinsuh Kim, Mali Mathru and 1 more

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In one paragraph

Article in Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 35% 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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Review
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

11 authors at 1 institution in 1 country.

Matthew S ParrDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.ORCID 0000-0003-1135-1159
Arsalaan SalehaniDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Mark OgilvieDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
B Ethan TabibianDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Sage RahmDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Andrew T HaleDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Georges Bouobda TsemoDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Akshay AluriHeersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Jinsuh KimDepartment of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Mali MathruDepartment of Anesthesiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Jesse G A JonesDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.ORCID 0000-0002-2682-9736
University of Alabama at Birmingham · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCarbon dioxide is a potent cerebral vasodilator that may influence outcomes after ischemic stroke. The objective of this study was to investigate the effect of intraprocedural mean end-tidal CO2 (ETCO2) levels on core infarct expansion and neurologic outcome following thrombectomy for anterior circulation ischemic stroke.

methodsA retrospective review was conducted of consecutive patients from March 2020 to June 2021 who underwent mechanical thrombectomy for acute anterior circulation ischemic stroke under general anesthesia and achieved successful recanalization (Thrombolysis in Cerebral Infarction [TICI] ≥ 2b). Only patients with CT perfusion, procedural ETCO2, and postoperative MRI data were included. Segmentation software was used for multi-parametric image analysis. Normocarbia defined as mean ETCO2 of 35 mmHg was used to dichotomize subjects. Univariate and multivariate statistics were applied.

resultsFifty-eight patients met criteria for analysis. Of these, 44 had TICI 3 recanalization, 9 had TICI 2c, and 5 had TICI 2b. Within this combined recanalization group, patients with mean ETCO2 > 35 had significantly higher rates of functional independence at 90 days. Although patients tended to salvage more penumbra and experience smaller final infarcts when ETCO2 exceeded 35 mmHg, this did not reach statistical significance.

conclusionsStroke patients who underwent successful thrombectomy with general anesthesia achieved higher rates of functional independence when procedural ETCO2 exceeded 35 mmHg. Further studies to confirm this effect and investigate optimal ETCO2 parameters should be considered.

Indexed as

Carbon DioxideIschemic StrokeThrombectomyAgedAged, 80 and overAnesthesia, GeneralFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedRetrospective StudiesTreatment OutcomeCarbon Dioxidecarbon dioxidestrokeThrombectomy

Identifiers

PMID36464668
PMCPMC11569468
OpenAlexW4310671771

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Registered trials

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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.