A comparison of conscious sedation and local anesthesia for thrombectomy in acute ischemic stroke: a multicenter study

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dc.authoridyabalak, ahmet/0000-0002-3317-9567
dc.authoridakpinar, cetin kursad/0000-0001-9512-1048;
dc.contributor.authorOnalan, Aysenur
dc.contributor.authorGurkas, Erdem
dc.contributor.authorAkpinar, Cetin Kursad
dc.contributor.authorAykac, Ozlem
dc.contributor.authorAcar, Turkan
dc.contributor.authorAcar, Bilgehan
dc.contributor.authorKocabas, Zehra Uysal
dc.date.accessioned2025-10-11T20:47:50Z
dc.date.available2025-10-11T20:47:50Z
dc.date.issued2024
dc.departmentDüzce Üniversitesien_US
dc.description.abstractIntroduction Ischemic cerebrovascular disease (ICVD) is a serious health problem in which brain tissue suffers from hypoxic damage due to obstruction in cerebral vessels. Mechanical thrombectomy is a commonly used method in the treatment of these patients. However, the effects of local anesthesia (LA) and conscious sedation (CS) during thrombectomy are still unclear. We evaluated whether there was a relationship between the two anesthesia regimens in terms of 90-day modified Rankin Scale (mRS) scores.Methods In this study, a retrospective observational study was conducted to evaluate the effects of LA and CS used during mechanical thrombectomy in four comprehensive stroke centers among ICVD patients. Patients were divided into the LA group and the CS group. Statistical analysis was performed before and after 1:1 matching under propensity score matching (PSM) analysis. The primary outcome measure was an mRS score of 0-2 at 90 days. Secondary outcomes were procedure times, recanalization rates, symptomatic and asymptomatic hemorrhage rates, and procedural complications.Results A total of 193 patients (118 patients with LA and 75 patients with CS) were included in the final analysis before PSM. After 1:1 PSM, 98 patients-49 patients from each group-were included in the study. There was no difference in clinical outcomes between the LA- and CS-applied groups (p = 0.543). When blood pressure (BP) values at follow-up after endovascular treatment (EVT) were compared, the lowest systolic and lowest diastolic BP were found to be lower in the CS group (p = 0.001 and p = 0.009). There was no significant difference between the two groups in terms of recanalization rates, symptomatic intracranial hemorrhage (sICH) rates, 90-day mRS, and procedure-related complication rates (p = 0.617, p = 0.274, p = 0.543, and p = 1.000).Conclusion This study did not reveal the superiority of CS applied during EVT on 90-day mRS, sICH, recanalization rates, or procedural complications. However, the risk of developing hypotension during the CS application was found to be high.en_US
dc.identifier.doi10.3389/fneur.2024.1416146
dc.identifier.issn1664-2295
dc.identifier.pmid39148701en_US
dc.identifier.scopus2-s2.0-85201550761en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.urihttps://doi.org/10.3389/fneur.2024.1416146
dc.identifier.urihttps://hdl.handle.net/20.500.12684/21599
dc.identifier.volume15en_US
dc.identifier.wosWOS:001290818600001en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherFrontiers Media Saen_US
dc.relation.ispartofFrontiers in Neurologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.snmzKA_WOS_20250911
dc.subjectconscious sedationen_US
dc.subjectlocal anesthesiaen_US
dc.subjectendovascular treatmenten_US
dc.subjectlarge vessel occlusionen_US
dc.subjectpropensity score matchingen_US
dc.titleA comparison of conscious sedation and local anesthesia for thrombectomy in acute ischemic stroke: a multicenter studyen_US
dc.typeArticleen_US

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