Leif H Sørensen 1 , Lasse Speiser 1 , Sanja Karabegovic 1 , Albert J Yoo 2 , Mads Rasmussen 3 , Kristina E Sørensen 4 , Claus Z Simonsen 4 Show Affiliations »
Abstract
Show RCT »
Hide RCT «
BACKGROUND: The "General or Local Anesthesia in Intra-Arterial Therapy" (GOLIATH ) trial compared infarct growth and outcome in patients undergoing endovascular therapy (EVT) under either general anesthesia (GA) or conscious sedation (CS ). The results were the same for the primary outcome (infarct growth) but successful reperfusion was higher in the GA arm. OBJECTIVE: To further examine differences in the quality and safety of EVT with the two anesthetic regimens in a post hoc analysis of GOLIATH. METHODS: In GOLIATH, 128 subjects with anterior circulation large vessel occlusion stroke within 6 hours of onset were randomized to either GA or CS (1:1 allocation). We compared the quality of reperfusion, treatment delay, use of catheters, and contrast and radiation dosage between the trial arms. RESULTS: Sixty-five subjects were randomized to GA . Baseline demographic and clinical variables were similar between the treatment arms. We found no difference in procedure time, contrast dose, or radiation dose between the two arms. Tandem occlusions were associated with a longer procedure time, but there was no difference between the two arms. There was no difference in reperfusion rates between the direct aspiration technique and a stent retriever (86% vs 79%, respectively, p=0.54), but aspiration was associated with a shorter procedure time (28 min vs 42 min for a stent retriever), p=0.03. CONCLUSION: Safety and quality of EVT under either GA and CS are comparable. TRIAL REGISTRATION: Unique identifier: NCT02317237;Post-results. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
RCT Entities: Population
Interventions
Outcomes
BACKGROUND: The "General or Local Anesthesia in Intra-Arterial Therapy" (GOLIATH) trial compared infarct growth and outcome in patients undergoing endovascular therapy (EVT ) under either general anesthesia (GA) or conscious sedation (CS ). The results were the same for the primary outcome (infarct growth ) but successful reperfusion was higher in the GA arm. OBJECTIVE: To further examine differences in the quality and safety of EVT with the two anesthetic regimens in a post hoc analysis of GOLIATH. METHODS: In GOLIATH, 128 subjects with anterior circulation large vessel occlusion stroke within 6 hours of onset were randomized to either GA or CS (1:1 allocation). We compared the quality of reperfusion, treatment delay, use of catheters, and contrast and radiation dosage between the trial arms. RESULTS: Sixty-five subjects were randomized to GA. Baseline demographic and clinical variables were similar between the treatment arms. We found no difference in procedure time, contrast dose, or radiation dose between the two arms. Tandem occlusions were associated with a longer procedure time, but there was no difference between the two arms. There was no difference in reperfusion rates between the direct aspiration technique and a stent retriever (86% vs 79%, respectively, p=0.54), but aspiration was associated with a shorter procedure time (28 min vs 42 min for a stent retriever), p=0.03. CONCLUSION: Safety and quality of EVT under either GA and CS are comparable. TRIAL REGISTRATION: Unique identifier: NCT02317237;Post-results. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Entities: Chemical
Disease
Gene
Species
Keywords:
MRI; stroke; thrombectomy
Mesh： See more »
Year: 2019
PMID： 30926686 DOI： 10.1136/neurintsurg-2019-014712
Source DB: PubMed Journal: J Neurointerv Surg ISSN： 1759-8478 Impact factor: 5.836