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Comment HERMES: a helpful messenger in the anaesthesia for thrombectomy debate?
The effectiveness of endovascular treatment in patients with anterior circulation ischaemic stroke due to large artery occlusion is firmly established, although optimal anaesthesia for the procedure remains contentious. Studies have suggested that endovascular treatment under general anaesthesia (GA) is associated with a worse outcome than when treatment is done without GA. However, because patients with more severe stroke and comorbidities are more likely to receive GA, there is potential for confounding by indication.
Source: Lancet Neurology - December 16, 2017 Category: Neurology Authors: Judith Dinsmore Tags: Comment Source Type: research

Articles Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data
Worse outcomes after endovascular thrombectomy were associated with GA, after adjustment for baseline prognostic variables. These data support avoidance of GA whenever possible. The procedure did, however, remain effective versus standard care in patients treated under GA, indicating that treatment should not be withheld in those who require anaesthesia for medical reasons.
Source: Lancet Neurology - December 16, 2017 Category: Neurology Authors: Bruce C V Campbell, Wim H van Zwam, Mayank Goyal, Bijoy K Menon, Diederik W J Dippel, Andrew M Demchuk, Serge Bracard, Philip White, Antoni D ávalos, Charles B L M Majoie, Aad van der Lugt, Gary A Ford, Natalia Pérez de la Ossa, Michael Kelly, Romain Bo Tags: Articles Source Type: research