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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2025
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| _version_ | 1849927636769308672 |
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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 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| 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 |