Effect of mode of anesthesia on radiation exposure in patients undergoing endovascular recanalization of anterior circulation embolic stroke.

Autor:	Hemmerich F; Department of Neuroradiology, University of Heidelberg, Heidelberg, Baden-Württemberg, Germany., Weyland CS; Department of Neuroradiology, University of Heidelberg, Heidelberg, Baden-Württemberg, Germany., Schönenberger S; Department of Neurology, University of Heidelberg, Heidelberg, Germany., Ringleb PA; Department of Neurology, University of Heidelberg, Heidelberg, Germany., Möhlenbruch MA; Department of Neuroradiology, University of Heidelberg, Heidelberg, Baden-Württemberg, Germany., Bendszus M; Department of Neuroradiology, University of Heidelberg, Heidelberg, Baden-Württemberg, Germany., Pfaff JA; Department of Neuroradiology, University of Heidelberg, Heidelberg, Baden-Württemberg, Germany.
Jazyk:	angličtina
Zdroj:	Journal of neurointerventional surgery [J Neurointerv Surg] 2020 May; Vol. 12 (5), pp. 455-459. Date of Electronic Publication: 2019 Sep 28.
DOI:	10.1136/neurintsurg-2019-015357
Abstrakt:	Purpose: To determine the effect of general anesthesia (GA) versus conscious sedation (CS) on radiation exposure (RE), procedure time (PT), and fluoroscopy time (FT) in patients receiving endovascular stroke treatment (EST) for large vessel occlusions (LVOs) in the anterior circulation. Methods: Retrospective analysis of an institutional review board-approved prospective stroke database of a comprehensive stroke center focusing on RE (as dose area product (DAP) in Gy.cm², median (IQR)), PT, and FT (in minutes, median (IQR)) in patients receiving EST for LVOs of the anterior circulation according to the mode of anesthesia during the intervention. Results: Overall 544 patients were included in this analysis (GA: n=143, CS: n=401). For all included LVOs in the anterior circulation PTs (GA: 69 (44-100); CS: 59 (37-99); p=0.235), FTs (GA: 33 (20-56); CS: 29 (16-51); p=0.286), and RE (DAP, GA: 116.23 (73.47-173.41); CS: 110.5 (68.35-184.65); p=0.929) were comparable. In a subgroup analysis of occlusions of the middle cerebral artery (M1-segment; GA: n=80/544, 14.7%; CS: n=211/544, 38.8%), PTs (GA: 69 (37-101); CS: 54 (35 - 89); p=0.223), FTs (GA: 33 (19-55); CS: 25 (14-48); p=0.264), and RE (DAP, GA: 110.91 (66.8-169.12); CS: 103.8 (63.17-181); p=0.893) were similar. Conclusion: In this retrospective analysis, no effect of the mode of anesthesia on the radiation exposure during EST was detected as GA and CS showed comparable PT, FT, and DAPs. Competing Interests: Competing interests: PAR: reports personal fees from Boehringer Ingelheim, Bayer, BMS, Daiichi Sankyo, and Covidien, outside the submitted work. MM: unrelated: board membership: Codman; consultancy: Medtronic, MicroVention, Stryker; grants/grants pending: Balt*, MicroVention*; payment for lectures Including service on speakers bureaus: Medtronic, MicroVention, Stryker. *Money paid to the institution. MB: activities related to this article: disclosed no relevant relationships. Activities not related to this article: grants and personal fees from Bayer, Codman, Guerbet, Medtronic, and Novartis; grants from the Hopp Foundation, Siemens, and Stryker; personal fees from Braun, Böhringer Ingelheim, Roche, Teva, and Vascular Dynamics. Other relationships: disclosed no relevant relationships. JARP: activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: travel and meeting expenses from Stryker and MicroVention. Other relationships: disclosed no relevant relationships. (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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