Evidence map›Paper›PMID 39160092›Full record

Trial reportStroke and vascular neurology2025

Anaesthesia modality on endovascular therapy outcomes in patients with large infarcts: a post hoc analysis of the ANGEL-ASPECT trial.

Fa Liang, Kangda Zhang, Youxuan Wu, Xinyan Wang, Xuan Hou, Yun Yu, Yunzhen Wang, Mengxing Wang, Yuesong Pan, Xiaochuan Huo and 2 more

Registry-linked trialAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Stroke and vascular neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04551664 (Study of Endovascular Therapy in Acute Anterior Circulation Large Vessel Occlusive Patients With a Large Infarct Core), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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.

NCT04551664 nacompletednot on this map

Study of Endovascular Therapy in Acute Anterior Circulation Large Vessel Occlusive Patients With a Large Infarct Core: A Multi-centered, Prospective, Open-label, Blind Endpoint, Randomized Controlled Trial(ANGEL-ASPECT)

TypeinterventionalSponsorBeijing Tiantan HospitalRan2020 to 2023Enrolled456ConditionsAcute Ischemic StrokeArmsBest medical management, Endovascular therapy
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

12 authors.

Fa LiangDepartment of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Kangda ZhangDepartment of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Youxuan WuDepartment of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Xinyan WangDepartment of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Xuan HouDepartment of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yun YuDepartment of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yunzhen WangDepartment of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Mengxing WangDepartment of Statistics, China National Clinical Research Center for Neurological Diseases, Beijing, China.ORCID 0000-0002-4245-4014
Yuesong PanDepartment of Statistics, China National Clinical Research Center for Neurological Diseases, Beijing, China.
Xiaochuan HuoDepartment of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.ORCID 0000-0003-1264-5132
Ruquan HanDepartment of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China ruquan.han@ccmu.edu.cn zhongrongm@163.com.ORCID 0000-0003-4335-8670
Zhongrong MiaoDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China ruquan.han@ccmu.edu.cn zhongrongm@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesEndovascular therapy (EVT) now penetrates the once obscure realm of large infarct core volume acute ischaemic stroke (LICV-AIS). This research aimed to investigate the potential correlation between different anaesthetic approaches and post-EVT outcomes in LICV-AIS patients.

methodsBetween October 2020 and May 2022, the China ANGEL-Alberta Stroke Programme Early CT Score (ASPECT) trial studied patients with LICV-AIS, randomly assigning them to the best medical management (BMM) or BMM with EVT. This post hoc subgroup analysis categorised subjects receiving BMM with EVT into general anaesthesia (GA) and non-GA groups based on anaesthesia type. We applied multivariable logistic regression to evaluate the relationship between anaesthesia during EVT and patient functional outcomes, as measured by the modified Rankin scale (mRS), in addition to the occurrence of complications. Further adjustment for selection bias was achieved through propensity score matching (PSM).

resultsIn total, 230 patients with LICV-AIS were enrolled (GA 84 vs Non-GA 146). No significant difference was observed between the two groups in terms of the proportion of patients who achieved an mRS score of 0-2 at 90 days (27.4% for the GA group vs 31.5% for the non-GA group, p=0.51). However, the GA group had significantly longer median surgical times (142 min vs 122 min, p=0.03). Furthermore, GA was associated with an increased risk of postoperative pneumonia (adjusted OR 2.03, 95% CI 1.04 to 3.98). The results of PSM analysis agreed with the results of the multivariate regression analysis. No significant difference in intracranial haemorrhage incidence or mortality rate was observed between the groups.

conclusionThis post hoc analysis of subgroups of the ANGEL-ASPECT trial suggested that there may be no significant association between the choice of anaesthesia and neurological outcomes in LICV-AIS patients. However, compared with non-GA, GA prolongs the duration of EVT and is associated with a greater postoperative pneumonia risk. TRIAL REGISTRATION NUMBER: NCT04551664.

Indexed as

Anesthesia, GeneralEndovascular ProceduresIschemic StrokeAgedAged, 80 and overChinaDisability EvaluationFemaleFunctional StatusHumansMaleMiddle AgedRecovery of FunctionRisk AssessmentRisk FactorsTime FactorsIschemic StrokeStroke

Identifiers

PMID39160092
PMCPMC12107463

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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.