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- Löwhagen Hendén, Pia, et al.
(författare)
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General Anesthesia Versus Conscious Sedation for Endovascular Treatment of Acute Ischemic Stroke: The AnStroke Trial (Anesthesia During Stroke).
- 2017
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Ingår i: Stroke. - 1524-4628. ; 48:6, s. 1601-1607
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Tidskriftsartikel (refereegranskat)abstract
- Retrospective studies have found that patients receiving general anesthesia for endovascular treatment in acute ischemic stroke have worse neurological outcome compared with patients receiving conscious sedation. In this prospective randomized single-center study, we investigated the impact of anesthesia technique on neurological outcome in acute ischemic stroke patients.Ninety patients receiving endovascular treatment for acute ischemic stroke in 2013 to 2016 were included and randomized to general anesthesia or conscious sedation. Difference in neurological outcome at 3 months, measured as modified Rankin Scale score, was analyzed (primary outcome) and early neurological improvement of National Institutes of Health Stroke Scale and cerebral infarction volume. Age, sex, comorbidities, admission National Institutes of Health Stroke Scale score, intraprocedural blood pressure, blood glucose, Paco2 and Pco2 modified Thrombolysis in Cerebral Ischemia score, and relevant time intervals were recorded.In the general anesthesia group 19 of 45 patients (42.2%) and in the conscious sedation group 18 of 45 patients (40.0%) achieved a modified Rankin Scale score ≤2 (P=1.00) at 3 months, with no differences in intraoperative blood pressure decline from baseline (P=0.57); blood glucose (P=0.94); PaCO2 (P=0.68); time intervals (P=0.78); degree of successful recanalization, 91.1% versus 88.9% (P=1.00); National Institutes of Health Stroke Scale score at 24 hours 8 (3-5) versus 9 (2-15; P=0.60); infarction volume, 20 (10-100) versus 20(10-54) mL (P=0.53); and hospital mortality (13.3% in both groups; P=1.00).In endovascular treatment for acute ischemic stroke, no difference was found between general anesthesia and conscious sedation in neurological outcome 3 months after stroke.URL: https://www.clinicaltrials.gov. Unique identifier: NCT01872884.
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| 2. |
- Rentzos, Alexandros, 1979, et al.
(författare)
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Endovascular treatment of acute ischemic stroke in the posterior circulation.
- 2018
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Ingår i: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. - : SAGE Publications. - 2385-2011. ; 24:4
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose Recent randomized clinical trials have proved the efficacy of endovascular treatment of acute ischemic stroke in the anterior circulation. However, the benefit of endovascular treatment of ischemic stroke in the posterior circulation remains to be proven since it was excluded from these trials. We evaluate the benefit of endovascular treatment in posterior circulation strokes. Methods A total of 110 consecutive patients with posterior circulation stroke who underwent endovascular treatment in our institute in the period 1991-2015 were included. Recanalization rate according to modified Treatment in Cerebral Ischemia score and neurological outcome at three months according to modified Rankin Scale were the main outcomes. Collateral circulation, procedural complications and radiological outcome were evaluated in the radiological examinations. Results The median National Institutes of Health Stroke Scale was 31 (IQR: 13-31) and median time from symptom onset to groin puncture was 300 (IQR: 175-463) minutes. Successful recanalization was seen in 80 of 110 patients (73%). Favorable outcome (modified Rankin Scale ≤2) was seen in 38 patients (35%) while moderate favorable outcome (≤3) was seen in 48 patients (44%). Symptomatic intracerebral hemorrhage occurred in 10 patients (9%). An association between collateral circulation, recanalization rate and outcome was seen. Conclusion Endovascular treatment for posterior circulation stroke in this single-center cohort is relatively safe and effective with decreased mortality and increased favorable outcome compared to natural history.
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| 3. |
- Skagervik, Ina, 1980, et al.
(författare)
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Brain CT perfusion in stroke in progression
- 2008
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Ingår i: European Neurology. - : S. Karger AG. - 0014-3022 .- 1421-9913. ; 59:1-2, s. 98-100
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Tidskriftsartikel (refereegranskat)
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| 4. |
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| 5. |
- Wikholm, Gunnar, 1948, et al.
(författare)
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Interventionell neuroradiologi vid ischemisk stroke
- 2014
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Ingår i: Stroke och cerebrovaskulär sjukdom. - Lund : Studentlitteratur. - 9789144086583 ; , s. 205-218
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Stroke och cerebrovaskulär sjukdom Stroke är den tredje vanligaste dödsorsaken i Sverige och den vanligaste somatiska orsaken till funktionsnedsättning hos vuxna, och därmed en av våra allvarligaste folksjukdomar. Denna bok ger en bred översikt över epidemiologi, anatomisk och fysiologisk bakgrund, profylax, farmakologiska och interventionella behandlingsstrategier och prognos vid stroke och cerebrovaskulär sjukdom. I denna andra upplaga har materialet angående strokesjukdomens olika komplikationer och rehabilitering efter stroke fördjupats. Nya kapitel om primärprevention, TIA, dissektioner, ovanliga stroketyper, emotionella reaktioner, kognitiv vaskulär svikt samt bilkörning efter stroke har tillkommit. Uppdaterade och utförliga beskrivningar ges av behandlingsformer, prevention, trombolys, interventionell kateterbehandling, endovaskulär stentning samt öppen kirurgi. Boken riktar sig till alla som är inblandade i behandling och vård av strokepatienter, i första hand specialister inom den öppna och slutna vården, men även till dem som handlägger dessa patienter mer sällan eller är under utbildning.
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