{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T15:16:37Z","timestamp":1791126997165,"version":"4.1.0"},"reference-count":28,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2023,5,1]]},"abstract":"\n Importance<\/jats:title>\n General anesthesia and procedural sedation are common practice for mechanical thrombectomy in acute ischemic stroke. However, risks and benefits of each strategy are unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine whether general anesthesia or procedural sedation for anterior circulation large-vessel occlusion acute ischemic stroke thrombectomy are associated with a difference in periprocedural complications and 3-month functional outcome.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This open-label, blinded end point randomized clinical trial was conducted between August 2017 and February 2020, with final follow-up in May 2020, at 10 centers in France.<\/jats:p>\n Adults with occlusion of the intracranial internal carotid artery and\/or the proximal middle cerebral artery treated with thrombectomy were enrolled.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Patients were assigned to receive general anesthesia with tracheal intubation (n\u2009=\u2009135) or procedural sedation (n\u2009=\u2009138).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The prespecified primary composite outcome was functional independence (a score of 0 to 2 on the modified Rankin Scale, which ranges from 0 [no neurologic disability] to 6 [death]) at 90 days and absence of major periprocedural complications (procedure-related serious adverse events, pneumonia, myocardial infarction, cardiogenic acute pulmonary edema, or malignant stroke) at 7 days.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 273 patients evaluable for the primary outcome in the modified intention-to-treat population, 142 (52.0%) were women, and the mean (SD) age was 71.6 (13.8) years. The primary outcome occurred in 38 of 135 patients (28.2%) assigned to general anesthesia and in 50 of 138 patients (36.2%) assigned to procedural sedation (absolute difference, 8.1 percentage points; 95% CI, \u22122.3 to 19.1;\n P<\/jats:italic>\n \u2009=\u2009.15). At 90 days, the rate of patients achieving functional independence was 33.3% (45 of 135) with general anesthesia and 39.1% (54 of 138) with procedural sedation (relative risk, 1.18; 95% CI, 0.86-1.61;\n P<\/jats:italic>\n \u2009=\u2009.32). The rate of patients without major periprocedural complications at 7 days was 65.9% (89 of 135) with general anesthesia and 67.4% (93 of 138) with procedural sedation (relative risk, 1.02; 95% CI, 0.86-1.21;\n P<\/jats:italic>\n \u2009=\u2009.80).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In patients treated with mechanical thrombectomy for anterior circulation acute ischemic stroke, general anesthesia and procedural sedation were associated with similar rates of functional independence and major periprocedural complications.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT03229148<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaneurol.2023.0413","type":"journal-article","created":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T11:04:50Z","timestamp":1680519890000},"page":"474","source":"Crossref","is-referenced-by-count":82,"title":["Outcomes After Endovascular Therapy With Procedural Sedation vs General Anesthesia in Patients With Acute Ischemic Stroke"],"prefix":"10.1001","volume":"80","author":[{"given":"Russell","family":"Chabanne","sequence":"first","affiliation":[{"name":"D\u00e9partement Anesth\u00e9sie R\u00e9animation et M\u00e9decine P\u00e9riop\u00e9ratoire, Centre Hospitalier Universitaire (CHU) de Clermont-Ferrand, Clermont-Ferrand, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Geeraerts","sequence":"additional","affiliation":[{"name":"D\u00e9partement Anesth\u00e9sie R\u00e9animation, Centre Hospitalier Universitaire (CHU) Toulouse, Universit\u00e9 Toulouse 3-Paul Sabatier, TONIC, INSERM, Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Begard","sequence":"additional","affiliation":[{"name":"D\u00e9partement Anesth\u00e9sie R\u00e9animation et M\u00e9decine P\u00e9riop\u00e9ratoire, Centre Hospitalier Universitaire (CHU) de Clermont-Ferrand, Clermont-Ferrand, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baptiste","family":"Balan\u00e7a","sequence":"additional","affiliation":[{"name":"Service d\u2019Anesth\u00e9sie R\u00e9animation, Neuroscience Research Center, Hospices Civils de Lyon, H\u00f4pital Neurologique Pierre Wertheimer and Universit\u00e9 Lyon 1, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Rapido","sequence":"additional","affiliation":[{"name":"Service d\u2019Anesth\u00e9sie R\u00e9animation, P\u00f4le Neurosciences T\u00eate et Cou, Centre Hospitalier Universitaire (CHU) de Montpellier, H\u00f4pital Gui de Chauliac, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Degos","sequence":"additional","affiliation":[{"name":"Anesth\u00e9sie et Neuro-R\u00e9animation chirurgicale Babinski, D\u00e9partement d\u2019Anesth\u00e9sie-R\u00e9animation, Assistance Publique H\u00f4pitaux de 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