Anaesthesiological Routine Care for Thrombectomy in Cerebral Ischaemia

Study Overview
=================
Brief Summary
-----------------
Endovascular thrombectomy is the standard of care for acute ischaemic stroke due to large-vessel occlusion. Current guidelines for periprocedural anaesthesiological care give gross recommendations on management of stroke patients during recanalization, but lack detailed information. To determine how anaesthesiologists support endovascular thrombectomy with regard to anaesthetic technique, choice of substances, haemodynamic management, and ventilation. With a multivariate analysis, the investigators will look for the factors of anesthetic management that are independently correlated with a good or bad outcome.

Detailed Description
-----------------
see brief summary

Official Title
-----------------
Anaesthesiological Routine Care for Thrombectomy in Cerebral Ischaemia

Conditions
-----------------
Cerebral Ischemia

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Endovascular stroke treatment involving anaesthesia care Exclusion Criteria: In-hospital onset of stroke Inclusion in an interventional study concerning the anaesthesia protocol Age under 18 years

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| A<br>Local | |
| B<br>Nested | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neurological outcome 90 days after the stroke | Neurological outcome is measured using the modified Rankin Scale [0-6], with higher values indicating worse outcome. As a Primary Outcome Measure, the scale will be dichotomized into good (modified Rankin Scale ≤ 2) versus poor (modified Rankin Scale > 2) outcome. | 90 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality | Mortality rate 90 days after the stroke. Mortality rate is the percentage of patients that have died within 90 days following their stroke. | 90 days | 
| Grade of recanalization | Recanalization is classified according to the modified Thrombolysis in Cerebral Infarction classification (mTICI) [0 - 3], with higher values indicating better reperfusion. | sixty minutes | 
| Duration | Duration [minutes] from patient's arrival in angiography suite to arterial puncture for endovascular thrombectomy. Duration [minutes] from patient's arrival in angiography suite to arterial puncture for endovascular thrombectomy. Duration [minutes] from arterial puncture to end of endovascular thrombectomy. | 30 Minutes | 
| Proportion of patients breathing spontaneously | Proportion of patients breathing spontaneously after thrombectomy [Time Frame: On transfer from angiography suite after thrombectomy, which typically takes 1 hour]. This is defined as percentage of patients that breathe spontaneously without laryngeal mask, laryngeal tube, or endotracheal tube after thrombectomy. | sixty minutes | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Endovascular thrombectomy, acute ischaemic stroke, large-vessel occlusion