skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: General Anesthesia Versus Conscious Sedation in Acute Stroke Treatment: The Importance of Head Immobilization

Abstract

PurposeWhile today mechanical thrombectomy is an established treatment option for main branch occlusions in anterior circulation stroke, there is still an ongoing debate on the kind of anesthesia to be preferred. Introducing a simple method for head stabilization, we analyzed safety and duration of endovascular recanalization procedures under general anesthesia (GA) and conscious sedation (CS).MethodsWe retrospectively identified 84 consecutive patients who underwent mechanical thrombectomy owing to acute anterior circulation stroke. Fifty-three were treated under GA and 31 under CS equipped with a standard cervical collar to reduce head movement. We evaluated recanalization results, in-house time to start recanalization, procedure times, technical and clinical complication rates, and conversion rates from CS to GA.ResultsRecanalization of mTICI ≥2b was achieved in 80 % under CS and in 81 % under GA. Median in-house time to start recanalization for CS was 60 min (IQR 28; 44–72) and 77 min (IQR 23; 68–91) for GA (P = 0.001). Median procedure time under CS was 35 min (IQR 43; 69–25) and 41 min (IQR 43; 66–23) for GA (P = 0.9). No major complications such as ICH occurred in either group, and no conversions from CS to GA were necessary.ConclusionMechanical thrombectomy can be performed faster and safely under CS in combination with simple head immobilization usingmore » a standard cervical collar.« less

Authors:
 [1];  [2];  [3]; ;  [1];  [4]
  1. Ludwig-Maximilians-University Hospital, Department of Neuroradiology (Germany)
  2. Ludwig-Maximilians-University Hospital, Department of Neurology (Germany)
  3. Paracelsus Medical University, Neurology/Research Institute of Neurointervention (Austria)
  4. Ingolstadt Hospital, Department of Neuroradiology (Germany)
Publication Date:
OSTI Identifier:
22645448
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 39; Journal Issue: 9; Other Information: Copyright (c) 2016 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANESTHESIA; BIOMEDICAL RADIOGRAPHY; DIAGNOSIS; HEAD; PATIENTS; SAFETY; STABILIZATION; STANDARDS; VASCULAR DISEASES; WHO

Citation Formats

Janssen, H., E-mail: hendrik.janssen@med.uni-muenchen.de, Buchholz, G., Killer, M., Ertl, L., Brückmann, H., and Lutz, J.. General Anesthesia Versus Conscious Sedation in Acute Stroke Treatment: The Importance of Head Immobilization. United States: N. p., 2016. Web. doi:10.1007/S00270-016-1411-5.
Janssen, H., E-mail: hendrik.janssen@med.uni-muenchen.de, Buchholz, G., Killer, M., Ertl, L., Brückmann, H., & Lutz, J.. General Anesthesia Versus Conscious Sedation in Acute Stroke Treatment: The Importance of Head Immobilization. United States. doi:10.1007/S00270-016-1411-5.
Janssen, H., E-mail: hendrik.janssen@med.uni-muenchen.de, Buchholz, G., Killer, M., Ertl, L., Brückmann, H., and Lutz, J.. Thu . "General Anesthesia Versus Conscious Sedation in Acute Stroke Treatment: The Importance of Head Immobilization". United States. doi:10.1007/S00270-016-1411-5.
@article{osti_22645448,
title = {General Anesthesia Versus Conscious Sedation in Acute Stroke Treatment: The Importance of Head Immobilization},
author = {Janssen, H., E-mail: hendrik.janssen@med.uni-muenchen.de and Buchholz, G. and Killer, M. and Ertl, L. and Brückmann, H. and Lutz, J.},
abstractNote = {PurposeWhile today mechanical thrombectomy is an established treatment option for main branch occlusions in anterior circulation stroke, there is still an ongoing debate on the kind of anesthesia to be preferred. Introducing a simple method for head stabilization, we analyzed safety and duration of endovascular recanalization procedures under general anesthesia (GA) and conscious sedation (CS).MethodsWe retrospectively identified 84 consecutive patients who underwent mechanical thrombectomy owing to acute anterior circulation stroke. Fifty-three were treated under GA and 31 under CS equipped with a standard cervical collar to reduce head movement. We evaluated recanalization results, in-house time to start recanalization, procedure times, technical and clinical complication rates, and conversion rates from CS to GA.ResultsRecanalization of mTICI ≥2b was achieved in 80 % under CS and in 81 % under GA. Median in-house time to start recanalization for CS was 60 min (IQR 28; 44–72) and 77 min (IQR 23; 68–91) for GA (P = 0.001). Median procedure time under CS was 35 min (IQR 43; 69–25) and 41 min (IQR 43; 66–23) for GA (P = 0.9). No major complications such as ICH occurred in either group, and no conversions from CS to GA were necessary.ConclusionMechanical thrombectomy can be performed faster and safely under CS in combination with simple head immobilization using a standard cervical collar.},
doi = {10.1007/S00270-016-1411-5},
journal = {Cardiovascular and Interventional Radiology},
number = 9,
volume = 39,
place = {United States},
year = {Thu Sep 15 00:00:00 EDT 2016},
month = {Thu Sep 15 00:00:00 EDT 2016}
}