scholarly journals Choice of ANaesthesia for EndoVAScular treatment of acute ischaemic stroke at posterior circulation (CANVAS II): protocol for an exploratory randomised controlled study

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e036358
Author(s):  
Fa Liang ◽  
Yan Zhao ◽  
Xiang Yan ◽  
Youxuan Wu ◽  
Xiuheng Li ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Endovascular Treatment ◽  
Acute Ischaemic Stroke ◽  
Neurological Outcome ◽  
Neurological Function ◽  
Posterior Circulation ◽  
Controlled Study ◽  
Randomised Controlled ◽  
Medical University ◽  
Type Of Anaesthesia

IntroductionObservational and interventional studies indicate that the type of anaesthesia may be associated with the postprocedural neurological function in patients with anterior circulation acute ischaemic stroke undergoing endovascular treatment. Patients with acute posterior circulation ischaemic stroke may experience different physiological changes and result in severe neurological outcome. However, the effect of the type of anaesthesia on postprocedure neurological function remained unclear in this population.Methods and analysisThis is an exploratory randomised controlled trial that will be carried out at Beijing Tiantan Hospital, Capital Medical University. Patients with acute posterior circulation ischaemic stroke and deemed suitable for emergency endovascular recanalisation will be recruited in this trial. Eighty-four patients will be randomised to receive either general anaesthesia or conscious sedation with 1:1 allocation ratio. The primary endpoint is the 90-day modified Rankin Scale.Ethics and disseminationThe study has been reviewed by and approved by Ethics Committee of Beijing Tiantan Hospital of Capital Medical University (KY2017-074-02). If the results are positive, the study will indicate whether the type of anaesthesia affects neurological outcome after endovascular treatment of posterior stroke. The findings of the study will be published in peer-reviewed journals and presented at national or international conferences.Trial registration numberNCT03317535.

scholarly journals Type of anaesthesia for acute ischaemic stroke endovascular treatment

2020 ◽  
Author(s):  
Renato Tosello ◽  
Rachel Riera ◽  
Giuliano Tosello ◽  
Caroline NB Clezar ◽  
Jorge E Amorim ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Endovascular Treatment ◽  
Acute Ischaemic Stroke ◽  
Type Of Anaesthesia

Value of machine learning to predict functional outcome of endovascular treatment for acute ischaemic stroke of the posterior circulation

2021 ◽  
pp. 197140092110490
Author(s):  
Ludger Feyen ◽  
Peter Schott ◽  
Hendrik Ochmann ◽  
Marcus Katoh ◽  
Patrick Haage ◽  
...  
Keyword(s):  
Machine Learning ◽  
Random Forest ◽  
Ischaemic Stroke ◽  
Endovascular Treatment ◽  
Linear Model ◽  
Acute Ischaemic Stroke ◽  
Favourable Outcome ◽  
Posterior Circulation ◽  
Nearest Neighbour ◽  
Modified Rankin Scale

Purpose Clinical outcomes vary considerably among individuals with vessel occlusion of the posterior circulation. In the present study we evaluated machine learning algorithms in their ability to discriminate between favourable and unfavourable outcomes in patients with endovascular treatment of acute ischaemic stroke of the posterior circulation. Methods This retrospective study evaluated three algorithms (generalised linear model, K-nearest neighbour and random forest) to predict functional outcomes at dismissal of 30 patients with acute occlusion of the basilar artery who were treated with thrombectomy. Input variables encompassed baseline as well as peri and postprocedural data. Favourable outcome was defined as a modified Rankin scale score of 0–2 and unfavourable outcome was defined as a modified Rankin scale score of 3–6. The performance of the algorithms was assessed with the area under the receiver operating curve and with confusion matrixes. Results Successful reperfusion was achieved in 83%, with 30% of the patients having a favourable outcome. The area under the curve was 0.93 for the random forest model, 0.86 for the K-nearest neighbour model and 0.78 for the generalised linear model. The accuracy was 0.69 for the generalised linear model and 0.84 for the random forest and the K nearest neighbour models. Conclusion Favourable and unfavourable outcomes at dismissal of patients with acute ischaemic stroke of the posterior circulation can be predicted immediately after the follow-up non-enhanced computed tomography using machine learning.

scholarly journals Efficacy and safety of butylphthalide for patients who had acute ischaemic stroke receiving intravenous thrombolysis or endovascular treatment (BAST trial): study protocol for a randomised placebo-controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045559
Author(s):  
Xuelei Zhang ◽  
Anxin Wang ◽  
Jing Yu Zhang ◽  
Baixue Jia ◽  
Xiaochuan Huo ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Endovascular Treatment ◽  
Functional Outcome ◽  
Acute Ischaemic Stroke ◽  
Controlled Trial ◽  
Intravenous Thrombolysis ◽  
Serious Adverse Events ◽  
Double Blind ◽  
Ischaemic Injury ◽  
Study Results

IntroductionAs a neuroprotective medication, butylphthalide (NBP) may help protect against cerebral ischaemic injury. However, evidence on whether NBP influences the outcomes of patients who had acute ischaemic stroke who are receiving revascularisation treatment is limited. This study aims to evaluate whether additional NBP therapy can improve the functional outcome of patients who receive intravenous recombinant tissue plasminogen activator and/or endovascular treatment (EVT).Methods and analysisThe study will be a randomised, double-blind, placebo-controlled, multiple-centre, parallel group trial. The sample size is estimated at 1200 patients. Eligible patients will be randomised at a 1:1 ratio to receive either NBP or placebo daily for 90 days, which will include 14 days of injections and 76 days of capsules. The first use of NBP/placebo will be started within 6 hours of onset of ischaemic stroke. The primary outcome is the functional outcome as assessed by the 90-day modified Rankin Scale, adjusted for baseline scores on the National Institutes of Health Stroke Scale. The primary safety outcome is the percentage of serious adverse events during the 90 days of treatment. This trial will determine whether NBP medication benefits patients who had acute ischaemic stroke who receive intravenous thrombolysis or EVT.Ethics and disseminationThe protocol was written according to the general ethical guidelines of the Declaration of Helsinki and approved by the Institutional Review Board/Ethics Committee of Beijing Tiantan Hospital, Capital Medical University with approval number KY 2018-003-02. Ethics committees of all participating sites have approved the study . Results of the study will be published in peer-reviewed scientific journals and shared in scientific presentations.Trial registration numberNCT03539445.

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