RT Journal Article
SR Electronic
T1 Safety and quality of endovascular therapy under general anesthesia and conscious sedation are comparable: results from the GOLIATH trial
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 1070
OP 1072
DO 10.1136/neurintsurg-2019-014712
VO 11
IS 11
A1 Leif H Sørensen
A1 Lasse Speiser
A1 Sanja Karabegovic
A1 Albert J Yoo
A1 Mads Rasmussen
A1 Kristina E Sørensen
A1 Claus Z Simonsen
YR 2019
UL http://jnis.bmj.com/content/11/11/1070.abstract
AB Background The “General or Local Anesthesia in Intra-Arterial Therapy” (GOLIATH) trial compared infarct growth and outcome in patients undergoing endovascular therapy (EVT) under either general anesthesia (GA) or conscious sedation (CS). The results were the same for the primary outcome (infarct growth) but successful reperfusion was higher in the GA arm.Objective To further examine differences in the quality and safety of EVT with the two anesthetic regimens in a post hoc analysis of GOLIATH.Methods In GOLIATH, 128 subjects with anterior circulation large vessel occlusion stroke within 6 hours of onset were randomized to either GA or CS (1:1 allocation). We compared the quality of reperfusion, treatment delay, use of catheters, and contrast and radiation dosage between the trial arms.Results Sixty-five subjects were randomized to GA. Baseline demographic and clinical variables were similar between the treatment arms. We found no difference in procedure time, contrast dose, or radiation dose between the two arms. Tandem occlusions were associated with a longer procedure time, but there was no difference between the two arms. There was no difference in reperfusion rates between the direct aspiration technique and a stent retriever (86% vs 79%, respectively, p=0.54), but aspiration was associated with a shorter procedure time (28 min vs 42 min for a stent retriever), p=0.03.Conclusion Safety and quality of EVT under either GA and CS are comparable.Trial registration Unique identifier: NCT02317237;Post-results.