Image 1_Effect of general anesthesia vs. local anesthesia and collateral status on outcomes in anterior circulation occlusion.jpeg

Background and objectives<p>The impact of anesthesia type on outcomes following endovascular thrombectomy (EVT) remains controversial. Collateral status assessed through perfusion imaging may provide critical insights for optimizing anesthesia strategies during EVT.</p>Methods<p>In...

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Autor principal: Guojie Chen (11804164) (author)
Otros Autores: Rundong Chen (14105694) (author), Tianxiang Gao (105958) (author), Lijun Wang (176511) (author), Hongye Xu (12262146) (author), Wen Yin (460575) (author), Yu Gao (69071) (author), Lei Zhang (38117) (author), Yongxin Zhang (32296) (author), Pengfei Xing (6827240) (author), Pengfei Yang (610220) (author), Zifu Li (1584457) (author), Yongwei Zhang (2333089) (author), Jianmin Liu (285775) (author)
Publicado: 2025
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author Guojie Chen (11804164)
author2 Rundong Chen (14105694)
Tianxiang Gao (105958)
Lijun Wang (176511)
Hongye Xu (12262146)
Wen Yin (460575)
Yu Gao (69071)
Lei Zhang (38117)
Yongxin Zhang (32296)
Pengfei Xing (6827240)
Pengfei Yang (610220)
Zifu Li (1584457)
Yongwei Zhang (2333089)
Jianmin Liu (285775)
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author_facet Guojie Chen (11804164)
Rundong Chen (14105694)
Tianxiang Gao (105958)
Lijun Wang (176511)
Hongye Xu (12262146)
Wen Yin (460575)
Yu Gao (69071)
Lei Zhang (38117)
Yongxin Zhang (32296)
Pengfei Xing (6827240)
Pengfei Yang (610220)
Zifu Li (1584457)
Yongwei Zhang (2333089)
Jianmin Liu (285775)
author_role author
dc.creator.none.fl_str_mv Guojie Chen (11804164)
Rundong Chen (14105694)
Tianxiang Gao (105958)
Lijun Wang (176511)
Hongye Xu (12262146)
Wen Yin (460575)
Yu Gao (69071)
Lei Zhang (38117)
Yongxin Zhang (32296)
Pengfei Xing (6827240)
Pengfei Yang (610220)
Zifu Li (1584457)
Yongwei Zhang (2333089)
Jianmin Liu (285775)
dc.date.none.fl_str_mv 2025-11-25T05:10:51Z
dc.identifier.none.fl_str_mv 10.3389/fneur.2025.1665185.s001
dc.relation.none.fl_str_mv https://figshare.com/articles/figure/Image_1_Effect_of_general_anesthesia_vs_local_anesthesia_and_collateral_status_on_outcomes_in_anterior_circulation_occlusion_jpeg/30703358
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Neurology and Neuromuscular Diseases
acute ischemic stroke
endovascular treatment
anesthesia
collateral status
propensity score matching
functional independence
dc.title.none.fl_str_mv Image 1_Effect of general anesthesia vs. local anesthesia and collateral status on outcomes in anterior circulation occlusion.jpeg
dc.type.none.fl_str_mv Image
Figure
info:eu-repo/semantics/publishedVersion
image
description Background and objectives<p>The impact of anesthesia type on outcomes following endovascular thrombectomy (EVT) remains controversial. Collateral status assessed through perfusion imaging may provide critical insights for optimizing anesthesia strategies during EVT.</p>Methods<p>In this retrospective cohort study, functional outcomes after EVT (measured by the modified Rankin Scale score) were compared between general anesthesia (GA) vs. local anesthesia (LA) using a propensity score-matched model. The association between the hypoperfusion intensity ratio (HIR, defined as Tmax > 10s/Tmax > 6 s) and outcomes was evaluated through weighted multivariate logistic regression, with potential non-linearity explored using restricted cubic spline (RCS) regression. To validate the findings, five analytical approaches were applied, including propensity score matching, multivariate logistic modeling adjusted for all covariates, inverse probability of treatment weighting (IPTW), and doubly robust estimations with and without adjustments for unbalanced covariates.</p>Results<p>A total of 702 patients were included, with 327 (46.6%) receiving GA and 375 (53.4%) receiving LA. Propensity score matching achieved balanced baseline characteristics (p > 0.05). Among patients with good collateral status (HIR <0.4), GA was associated with worse functional outcomes (mRS 0–2: 49% vs. 70%; OR 2.88, 95% CI: 1.29–6.43). In patients with poor collateral status, outcomes were comparable between GA and LA (mRS 0–2: 50% vs. 59%; OR 1.73, 95% CI: 0.92–3.27). All five statistical models yielded consistent results.</p>Conclusions<p>There is an association between general anesthesia and poorer functional prognosis in patients with well-developed collateral circulation after endovascular thrombectomy (EVT). HIR may serve as a useful marker for anesthesia selection and triage in EVT.</p>Classification of evidence<p>This study provides Class III evidence that use of GA is associated with worse functional outcome in patients with good collateral that undergoing EVT.</p>
eu_rights_str_mv openAccess
id Manara_1de2720e7d0abf5f38551354ba9f213a
identifier_str_mv 10.3389/fneur.2025.1665185.s001
network_acronym_str Manara
network_name_str ManaraRepo
oai_identifier_str oai:figshare.com:article/30703358
publishDate 2025
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rights_invalid_str_mv CC BY 4.0
spelling Image 1_Effect of general anesthesia vs. local anesthesia and collateral status on outcomes in anterior circulation occlusion.jpegGuojie Chen (11804164)Rundong Chen (14105694)Tianxiang Gao (105958)Lijun Wang (176511)Hongye Xu (12262146)Wen Yin (460575)Yu Gao (69071)Lei Zhang (38117)Yongxin Zhang (32296)Pengfei Xing (6827240)Pengfei Yang (610220)Zifu Li (1584457)Yongwei Zhang (2333089)Jianmin Liu (285775)Neurology and Neuromuscular Diseasesacute ischemic strokeendovascular treatmentanesthesiacollateral statuspropensity score matchingfunctional independenceBackground and objectives<p>The impact of anesthesia type on outcomes following endovascular thrombectomy (EVT) remains controversial. Collateral status assessed through perfusion imaging may provide critical insights for optimizing anesthesia strategies during EVT.</p>Methods<p>In this retrospective cohort study, functional outcomes after EVT (measured by the modified Rankin Scale score) were compared between general anesthesia (GA) vs. local anesthesia (LA) using a propensity score-matched model. The association between the hypoperfusion intensity ratio (HIR, defined as Tmax > 10s/Tmax > 6 s) and outcomes was evaluated through weighted multivariate logistic regression, with potential non-linearity explored using restricted cubic spline (RCS) regression. To validate the findings, five analytical approaches were applied, including propensity score matching, multivariate logistic modeling adjusted for all covariates, inverse probability of treatment weighting (IPTW), and doubly robust estimations with and without adjustments for unbalanced covariates.</p>Results<p>A total of 702 patients were included, with 327 (46.6%) receiving GA and 375 (53.4%) receiving LA. Propensity score matching achieved balanced baseline characteristics (p > 0.05). Among patients with good collateral status (HIR <0.4), GA was associated with worse functional outcomes (mRS 0–2: 49% vs. 70%; OR 2.88, 95% CI: 1.29–6.43). In patients with poor collateral status, outcomes were comparable between GA and LA (mRS 0–2: 50% vs. 59%; OR 1.73, 95% CI: 0.92–3.27). All five statistical models yielded consistent results.</p>Conclusions<p>There is an association between general anesthesia and poorer functional prognosis in patients with well-developed collateral circulation after endovascular thrombectomy (EVT). HIR may serve as a useful marker for anesthesia selection and triage in EVT.</p>Classification of evidence<p>This study provides Class III evidence that use of GA is associated with worse functional outcome in patients with good collateral that undergoing EVT.</p>2025-11-25T05:10:51ZImageFigureinfo:eu-repo/semantics/publishedVersionimage10.3389/fneur.2025.1665185.s001https://figshare.com/articles/figure/Image_1_Effect_of_general_anesthesia_vs_local_anesthesia_and_collateral_status_on_outcomes_in_anterior_circulation_occlusion_jpeg/30703358CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/307033582025-11-25T05:10:51Z
spellingShingle Image 1_Effect of general anesthesia vs. local anesthesia and collateral status on outcomes in anterior circulation occlusion.jpeg
Guojie Chen (11804164)
Neurology and Neuromuscular Diseases
acute ischemic stroke
endovascular treatment
anesthesia
collateral status
propensity score matching
functional independence
status_str publishedVersion
title Image 1_Effect of general anesthesia vs. local anesthesia and collateral status on outcomes in anterior circulation occlusion.jpeg
title_full Image 1_Effect of general anesthesia vs. local anesthesia and collateral status on outcomes in anterior circulation occlusion.jpeg
title_fullStr Image 1_Effect of general anesthesia vs. local anesthesia and collateral status on outcomes in anterior circulation occlusion.jpeg
title_full_unstemmed Image 1_Effect of general anesthesia vs. local anesthesia and collateral status on outcomes in anterior circulation occlusion.jpeg
title_short Image 1_Effect of general anesthesia vs. local anesthesia and collateral status on outcomes in anterior circulation occlusion.jpeg
title_sort Image 1_Effect of general anesthesia vs. local anesthesia and collateral status on outcomes in anterior circulation occlusion.jpeg
topic Neurology and Neuromuscular Diseases
acute ischemic stroke
endovascular treatment
anesthesia
collateral status
propensity score matching
functional independence