Evidence map›Paper›PMID 38687365›Full record

ArticleClinical neuroradiology2024

Outcomes with General Anesthesia Compared to Conscious Sedation for Endovascular Treatment of Medium Vessel Occlusions: Results of an International Multicentric Study.

Răzvan Alexandru Radu, Vincent Costalat, Michele Romoli, Basel Musmar, James E Siegler, Sherief Ghozy, Jane Khalife, Hamza Salim, Hamza Shaikh, Nimer Adeeb and 89 more

Abstract readMulticenter StudyComparative Study
PubMed Publisher
In one paragraph

Article in Clinical neuroradiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

22 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  10. Hypoperfusion intensity ratio is associated with follow-up infarct volume in medium vessel occlusions: A multicenter multinational study.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
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  11. Baseline predictors of poor clinical outcome despite recanalization of distal middle cerebral artery occlusions.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025
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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

99 authors.

Răzvan Alexandru RaduDepartment of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France. raduarazvan@yahoo.com.
Vincent CostalatDepartment of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.
Michele RomoliNeurology and Stroke Unit, Bufalini Hospital, AUSL Romagna, Cesena, Italy.
Basel MusmarDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Louisiana, LA, USA.
James E SieglerCooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA.
Sherief GhozyDepartments of Neurological Surgery & Radiology, Mayo Clinic, Rochester, MN, USA.
Jane KhalifeCooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA.
Hamza SalimDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Louisiana, LA, USA.
Hamza ShaikhCooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA.
Nimer AdeebDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Louisiana, LA, USA.
Hugo H Cuellar-SaenzDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Louisiana, LA, USA.
Ajith J ThomasCooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA.
Ramanathan KadirvelDepartments of Neurological Surgery & Radiology, Mayo Clinic, Rochester, MN, USA.
Mohamad AbdalkaderDepartments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA.
Piers KleinDepartments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA.
Thanh N NguyenDepartments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA.
Jeremy J HeitDepartment of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, CA, USA.
Robert W RegenhardtNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Joshua D BernstockNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Aman B PatelNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
James D RabinovNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Christopher J StapletonNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Nicole M CancelliereNeurovascular Centre, Departments of Medical Imaging and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada.
Thomas R MarottaNeurovascular Centre, Departments of Medical Imaging and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada.
Vitor Mendes PereiraNeurovascular Centre, Departments of Medical Imaging and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada.
Kareem El NaamaniDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
Abdelaziz AmllayDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
Stavropoula I TjoumakarisDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
Pascal JabbourDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
Lukas MeyerDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Jens FiehlerDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Tobias D FaizyDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Helena GuerreiroDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Anne DusartDepartment of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium.
Flavio BellanteDepartment of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium.
Géraud ForestierUniversity Hospital of Limoges, Neuroradiology Department, Dupuytren, Université de Limoges, XLIM CNRS, UMR 7252, Limoges, France.
Aymeric RouchaudUniversity Hospital of Limoges, Neuroradiology Department, Dupuytren, Université de Limoges, XLIM CNRS, UMR 7252, Limoges, France.
Charbel MounayerUniversity Hospital of Limoges, Neuroradiology Department, Dupuytren, Université de Limoges, XLIM CNRS, UMR 7252, Limoges, France.
Anna Luisa KühnDivision of Neurointerventional Radiology, Department of Radiology, University of Massachusetts Medical Center, Worcester, MA, USA.
Ajit S PuriDivision of Neurointerventional Radiology, Department of Radiology, University of Massachusetts Medical Center, Worcester, MA, USA.
Christian DyzmannNeuroradiology Department, Sana Kliniken, Lübeck GmbH, Lübeck, Germany.
Peter T KanDepartment of Neurosurgery, University of Texas Medical Branch, Galveston, TX, USA.
Marco ColasurdoDepartment of Neurosurgery, University of Texas Medical Branch, Galveston, TX, USA.
Gaultier MarnatInterventional Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France.
Jérôme BergeInterventional Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France.
Xavier BarreauInterventional Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France.
Igor SibonNeurology Department, Bordeaux University Hospital, Bordeaux, France.
Simona NedelcuDepartment of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Nils HenningerDepartment of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Takahiro OtaDepartment of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
Shogo DofukuDepartment of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
Leonard L L YeoDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Benjamin Yq TanDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Anil GopinathanDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Juan Carlos Martinez-GutierrezDepartment of Neurology, UTHealth McGovern Medical School, Houston, TX, USA.
Sergio Salazar-MarioniDepartment of Neurology, UTHealth McGovern Medical School, Houston, TX, USA.
Sunil ShethDepartment of Neurology, UTHealth McGovern Medical School, Houston, TX, USA.
Leonardo RenieriInterventistica Neurovascolare, Ospedale Careggi di Firenze, Florence, Italy.
Carolina CapirossiInterventistica Neurovascolare, Ospedale Careggi di Firenze, Florence, Italy.
Ashkan MowlaDivision of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), North State St, Suite 3300, 1200, Los Angeles, CA, USA.
Lina M ChervakDepartment of Neurology and Radiology, University of Cincinnati, Cincinnati, USA.
Achala VagalDepartment of Neurology and Radiology, University of Cincinnati, Cincinnati, USA.
Priyank KhandelwalDepartment of Endovascular Neurosurgery and Neuroradiology NJMS, Newark, NJ, USA.
Arundhati BiswasDepartment of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, USA.
Frédéric ClarençonDepartment of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.
Mahmoud ElhoranyDepartment of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.
Kevin PrematDepartment of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.
Iacopo ValenteUOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A.Gemelli IRCCS Roma, Rome, Italy.
Alessandro PedicelliUOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A.Gemelli IRCCS Roma, Rome, Italy.
Andrea M AlexandreUOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A.Gemelli IRCCS Roma, Rome, Italy.
João Pedro FilipeDepartment of Diagnostic and Interventional Neuroradiology, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Ricardo VarelaDepartment of Neurology, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Miguel Quintero-ConsuegraDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, USA.
Nestor R GonzalezDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, USA.
Markus A YmdSektion Vaskuläre und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany.
Jessica JesserSektion Vaskuläre und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany.
Charlotte WeylandSektion Vaskuläre und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany.
Adrien Ter SchiphorstDepartment of Neurology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.
Vivek YedavalliDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Pablo HarkerDepartment of Neurology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Yasmin AzizDepartment of Neurology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Benjamin GoryDepartment of Interventional Neuroradiology, Nancy University Hospital, Nancy, France.
Christian Paul StrackeDepartment of Radiology, Interventional Neuroradiology Section, University Medical Center Münster, Munster, Germany.
Constantin HeckerDepartments of Neurology & Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University Salzburg, Salzburg, Austria.
Monika Killer-OberpfalzerDepartments of Neurology & Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University Salzburg, Salzburg, Austria.
Christoph J GriessenauerDepartments of Neurology & Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University Salzburg, Salzburg, Austria.
Cheng-Yang HsiehNeurology Department, Sin-Lau Hospital, Tainan, Taiwan, Province of China.
David S LiebeskindUCLA Stroke Center and Department of Neurology Department, UCLA, Los Angeles, California, USA.
Illario TancrediDepartment of Medicine, Division of Neurology, The Ottawa Hospital, Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Ontario, Canada.
Robert FahedDepartment of Medicine, Division of Neurology, The Ottawa Hospital, Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Ontario, Canada.
Boris LubiczDepartment of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium.
Muhammed Amir EssibayiDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Amanda BakerDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
David AltschulDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Luca ScarciaDepartment of Neuroradiology, Henri Mondor Hospital, Creteil, France.
Erwah KalsoumDepartment of Neuroradiology, Henri Mondor Hospital, Creteil, France.
Adam A DmytriwNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Adrien GuenegoDepartment of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium.
MAD-MT Consortium

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOptimal anesthetic strategy for the endovascular treatment of stroke is still under debate. Despite scarce data concerning anesthetic management for medium and distal vessel occlusions (MeVOs) some centers empirically support a general anesthesia (GA) strategy in these patients.

methodsWe conducted an international retrospective study of MeVO cases. A propensity score matching algorithm was used to mitigate potential differences across patients undergoing GA and conscious sedation (CS). Comparisons in clinical and safety outcomes were performed between the two study groups GA and CS. The favourable outcome was defined as a modified Rankin Scale (mRS) 0-2 at 90 days. Safety outcomes were 90-days mortality and symptomatic intracranial hemorrhage (sICH). Predictors of a favourable outcome and sICH were evaluated with backward logistic regression.

resultsAfter propensity score matching 668 patients were included in the CS and 264 patients in the GA group. In the matched cohort, either strategy CS or GA resulted in similar rates of good functional outcomes (50.1% vs. 48.4%), and successful recanalization (89.4% vs. 90.2%). The GA group had higher rates of 90-day mortality (22.6% vs. 16.5%, p < 0.041) and sICH (4.2% vs. 0.9%, p = 0.001) compared to the CS group. Backward logistic regression did not identify GA vs CS as a predictor of good functional outcome (OR for GA vs CS = 0.95 (0.67-1.35)), but GA remained a significant predictor of sICH (OR = 5.32, 95% CI 1.92-14.72).

conclusionAnaesthetic strategy in MeVOs does not influence favorable outcomes or final successful recanalization rates, however, GA may be associated with an increased risk of sICH and mortality.

Indexed as

Anesthesia, GeneralEndovascular ProceduresProcedural SedationPropensity ScoreAgedFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeAnesthesiaMeVOOutcomes researchReperfusionStrokeThrombectomy

Identifiers

PMID38687365

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