Anaesthesiological Routine Care for Thrombectomy in Cerebral Ischaemia

European Society of Anaesthesiology2,500 enrolled

Overview

Endovascular thrombectomy is the standard of care for acute ischaemic stroke due to large-vessel occlusion. Current guidelines for periprocedural anaesthesiological care give gross recommendations on management of stroke patients during recanalization, but lack detailed information. To determine how anaesthesiologists support endovascular thrombectomy with regard to anaesthetic technique, choice of substances, haemodynamic management, and ventilation. With a multivariate analysis, the investigators will look for the factors of anesthetic management that are independently correlated with a good or bad outcome.

see brief summary

Study Type

OBSERVATIONAL

Enrollment

2,500

Conditions

Cerebral Ischemia

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Endovascular stroke treatment involving anaesthesia care Exclusion Criteria: * In-hospital onset of stroke * Inclusion in an interventional study concerning the anaesthesia protocol * Age under 18 years

Locations (1)

TU München

München, Germany

Outcomes

Primary Outcomes

Neurological outcome 90 days after the stroke

Neurological outcome is measured using the modified Rankin Scale \[0-6\], with higher values indicating worse outcome. As a Primary Outcome Measure, the scale will be dichotomized into good (modified Rankin Scale ≤ 2) versus poor (modified Rankin Scale \> 2) outcome.

Time frame: 90 days

Secondary Outcomes

Mortality

Mortality rate 90 days after the stroke. Mortality rate is the percentage of patients that have died within 90 days following their stroke.

Time frame: 90 days

Grade of recanalization

Recanalization is classified according to the modified Thrombolysis in Cerebral Infarction classification (mTICI) \[0 - 3\], with higher values indicating better reperfusion.

Time frame: sixty minutes

Duration

Duration \[minutes\] from patient's arrival in angiography suite to arterial puncture for endovascular thrombectomy. Duration \[minutes\] from patient's arrival in angiography suite to arterial puncture for endovascular thrombectomy. Duration \[minutes\] from arterial puncture to end of endovascular thrombectomy.

Time frame: 30 Minutes

Proportion of patients breathing spontaneously

Proportion of patients breathing spontaneously after thrombectomy \[Time Frame: On transfer from angiography suite after thrombectomy, which typically takes 1 hour\]. This is defined as percentage of patients that breathe spontaneously without laryngeal mask, laryngeal tube, or endotracheal tube after thrombectomy.