Evidence map›Paper›PMID 40859303›Full record

ArticleNeurological research and practice2025

Feasibility of non-invasive neuromonitoring using BIS and NIRS during endovascular treatment of acute ischemic stroke.

David Batra, Min Chen, Jan Meis, Markus A Möhlenbruch, Christina Klose, Peter Ringleb, Vishank Shah, Julian Bösel, Silvia Schönenberger

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Article in Neurological research and practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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0cells of the map it votes in
3citing papers in PubMed
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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

David BatraDepartment of Neurology, Heidelberg University Hospital, Heidelberg, Germany. David.batra@med.uni-heidelberg.de.ORCID http://orcid.org/0009-0008-1021-3591
Min ChenDepartment of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
Jan MeisInstitute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.
Markus A MöhlenbruchDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
Christina KloseInstitute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.
Peter RinglebDepartment of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
Vishank ShahDepartment of Neurology, Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Julian BöselDepartment of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
Silvia SchönenbergerDepartment of Neurology, Heidelberg University Hospital, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEndovascular thrombectomy (EVT)-often combined with intravenous thrombolysis-is the standard of care for acute ischemic stroke (AIS) secondary to large vessel occlusions (LVO). While indications keep expanding, the feasibility and utility of intra-procedural neuromonitoring of the sedated patient has neither been clarified nor characterized.

objectiveTo evaluate the feasibility of near-infrared spectroscopy (NIRS) for cortical oxygenation and bispectral index (BIS) for electroencephalographic function as non-invasive neuromonitoring tools for AIS patients undergoing EVT, and assess their utility in predicting successful recanalization.

methodsWe extracted data on all patients receiving continuous NIRS and/or BIS monitoring in the Sedation versus Intubation for Endovascular Stroke TreAtment (SIESTA) clinical trial. SIESTA randomized AIS patients undergoing EVT for anterior proximal LVO to general anesthesia versus conscious sedation. For this analysis, the primary outcomes included changes in NIRS and BIS values pre- and post-recanalization and associations of parameter changes with successful or unsuccessful recanalization outcomes. Statistical analysis was performed using a Wilcoxon signed rank tests.

resultsOf the 150 patients, 66 were monitored continuously with NIRS, and 50 with BIS. An increased NIRS-derived cerebral tissue oxygenation (stated as tissue saturation index - TSI) was observed in affected hemisphere following successful recanalization, as well as a significant reduction in the difference between affected and unaffected hemispheres. In contrast, no significant changes were observed with BIS monitoring between pre- and post-recanalization status.

conclusionIn this post-hoc analysis, changes in NIRS monitoring were associated with successful reperfusion. Non-invasive oximetry by NIRS may serve as a valuable tool during and after mechanical thrombectomy to detect and respond to an insufficient perfusion or re-occlusion.

Identifiers

PMID40859303
PMCPMC12382210

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