Skip to main content

ORIGINAL RESEARCH article

Front. Anesthesiol.
Sec. Neuroanesthesiology
Volume 3 - 2024 | doi: 10.3389/fanes.2024.1388407

Stroke Metric Changes Pre-versus Post-Routine Anesthesiologist Involvement for Endovascular Treatment of Acute Ischemic Stroke

Provisionally accepted
Natalie Rall Natalie Rall 1*Walter Orr Walter Orr 2*Niaman Nazir Niaman Nazir 2Grace Giron Grace Giron 2Erin Plaza Erin Plaza 2*
  • 1 School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States
  • 2 Department of Anesthesiology, University of Kansas Medical Center, Kansas City, Kansas, United States

The final, formatted version of the article will be published soon.

    Background: Timing of endovascular treatment (EVT) for acute ischemic stroke (AIS) is important for patient outcomes. Studies have evaluated how anesthesia type may affect patient outcomes and timing of EVT for AIS, but there is limited data regarding how the presence of an anesthesia team can affect these metrics. The study aimed to compare time metrics and patient outcomes pre-versus post-routine involvement of a dedicated anesthesia team with EVT cases.Methods: All patients at our institution between 18 and 100 years old that were evaluated for stroke and determined to be candidates for EVT between November 2018 and November 2020 were considered for this study. Time metrics associated with EVT, which are commonly tracked by stroke centers, were compared pre-versus post-routine involvement of a dedicated anesthesia team in EVT cases. Secondary outcomes included modified Rankin Score at time of discharge, NIH Stroke Scale score at time of presentation and discharge, and incidence of intraprocedural hypotension.Results: 255 patients were included. Comparing pre-(n=119) vs post-neuroanesthesia team involvement (n=136) in EVT for AIS, there was a statistically significant decrease in median time from puncture to TICI score >2b in the in-house group from 49.00 minutes pre-involvement to 23.00 minutes post-involvement (P = 0.02) and puncture to TICI > 2b (39.5 vs 34 minutes, P = 0.01) for all patient categories when controlling for anesthesia type. The incidence of intraprocedural hypotension (MAP < 65 mmHg) also decreased significantly from 79% to 44% (P = 0.04), though it was not significant when controlling for anesthesia type (P = 0.05).Conclusions: Routine involvement of a dedicated anesthesia team for EVT in AIS patients could potentially improve stroke metrics and patient outcomes, though more studies are necessary to validate this model of care.

    Keywords: Stroke, ischemic stroke, Time to treatment, Endovascular Procedures, Anesthesia

    Received: 19 Feb 2024; Accepted: 26 Jun 2024.

    Copyright: © 2024 Rall, Orr, Nazir, Giron and Plaza. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Natalie Rall, School of Medicine, University of Kansas Medical Center, Kansas City, 66160, Kansas, United States
    Walter Orr, Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS 66160, Kansas, United States
    Erin Plaza, Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS 66160, Kansas, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.