Evidence map›Paper›PMID 39179003›Full record

ArticleJournal of vascular surgery2024

Impact of the type of anesthesia on adverse events during transcarotid artery revascularization.

Brajesh K Lal, Minerva Mayorga-Carlin, Shalini Sahoo, Richard Cambria, Joseph D Raffetto, Warren Gasper, Mila Ju, Sumaira Macdonald, John D Sorkin

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of vascular surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Brajesh K LalDepartment of Vascular Surgery, University of Maryland School of Medicine, Vascular Service, Baltimore VA Medical Center, Baltimore, MD; Department of Vascular Surgery, University of Maryland School of Medicine, Baltimore, MD. Electronic address: blal@som.umaryland.edu.
Minerva Mayorga-CarlinDepartment of Vascular Surgery, University of Maryland School of Medicine, Baltimore, MD.
Shalini SahooDepartment of Vascular Surgery, University of Maryland School of Medicine, Vascular Service, Baltimore VA Medical Center, Baltimore, MD.
Richard CambriaDepartment of Vascular Surgery, University of Maryland School of Medicine, Baltimore, MD.
Joseph D RaffettoDivision of Vascular and Endovascular Surgery, St Elizabeth's Medical Center, Boston, MA; Department of Surgery, Harvard Medical School, Vascular Service, VA Boston Healthcare System, Boston, MA.
Warren GasperDivision of Vascular and Endovascular Surgery, Department of Surgery, University of California San Francisco, Vascular Service, San Francisco VA Medical Center, San Francisco, CA, USA; Department of Vascular and Endovascular Surgery, Lehigh Valley Health Network, Allentown, PA, USA.
Mila JuSilk Road Medical, Sunnyvale, CA.
Sumaira MacdonaldDepartment of Medicine, University of Maryland School of M, Baltimore VA Medical Center, Baltimore, MD, USA.
John D SorkinDepartment of Medicine, University of Maryland School of Medicine, Geriatric Research, Education, and Clinical Center, Baltimore VA Medical Center, Baltimore, MD, USA.

Funding

CREST-2 Clinical Coordinating CenterU01NS080168 · NINDS · MAYO CLINIC JACKSONVILLE · PI Thomas G Brott, JAMES F MESCHIA · 2014 to 2026
$56.3M
University of Maryland Claude D. Pepper Older Americans Independence Center (UM-OAIC)P30AG028747 · NIA · UNIVERSITY OF MARYLAND BALTIMORE · PI ALICE S. RYAN · 2006 to 2026
$28.9M
Healthy Aging Neighborhoods of Diversity Across LifespanZ01AG000513 · NIA · NATIONAL INSTITUTE ON AGING · PI EVANS, MICHELE K · 2001 to 2008
$6.8M
Carotid Revascularization and Medical Management for Asymptomatic CarotidStenosis Trial - Hemodynamics (CREST-H)R01NS097876 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI RONALD M LAZAR, DAVID SIGMUND LIEBESKIND · 2017 to 2026
$6.4M
Role of a Novel Exercise Program to Prevent Post-thrombotic SyndromeI01RX000995 · VA · BALTIMORE VA MEDICAL CENTER · PI LAL, BRAJESH K · 2015 to 2020
–
Asymptomatic Carotid Stenosis: Cognitive Function and Plaque CorrelatesI01CX000407 · VA · BALTIMORE VA MEDICAL CENTER · PI LAL, BRAJESH K · 2011 to 2014
–
Asymptomatic Carotid Stenosis: Cognitive Function and Plaque Correlates - 2I01CX001621 · VA · BALTIMORE VA MEDICAL CENTER · PI LAL, BRAJESH K · 2017 to 2021
–
CSRD VA I01 CX000407CSRD VA I01 CX001621Intramural NIH HHS Z01 AG000513NIA NIH HHS P30 AG028747NINDS NIH HHS R01 NS097876NINDS NIH HHS U01 NS080168RRD VA I01 RX000995
6 · The paper itself

Abstract

objectiveThe use of local or regional anesthesia (LRA) is encouraged during transcarotid artery revascularization (TCAR) because the procedure is performed through a small incision. LRA permits neurologic evaluation during the procedure and may reduce periprocedural cardiac morbidity compared with general anesthesia (GA). There is limited and conflicting information regarding the preferred anesthesia to use during TCAR. We compared periprocedural clinical and technical complications, and intraprocedural performance metrics of TCAR performed under GA vs LRA.

methodsPatient, lesion, physician, and procedural information was collected in a worldwide quality assurance program of consecutive TCAR procedures. A composite clinical adverse event rate (death, stroke, transient ischemic attack, myocardial infarction) and a composite technical adverse event rate (aborted procedure, conversion to carotid endarterectomy, bleeding, dissection, cranial-nerve injury, device failure) in the periprocedural period were computed. Four intraprocedural performance measures (flow-reversal time, fluoroscopy time, contrast volume, and skin-to-skin time) were recorded. Deidentified data were analyzed independently at the Center for Vascular Research, University of Maryland. Poisson regressions were used to assess the impact of anesthesia type on adverse event rates. Linear regressions were used to compare performance measures.

resultsA total of 27,043 TCARs were performed by 1456 physicians between 2012 and 2021. A majority of patients (83%) received GA, and this proportion increased over time (R

conclusionsAlmost two-thirds of physicians performed TCAR exclusively under GA, and the overall proportion of procedures performed under GA increased over time. A larger fraction of patients with severe medical risk factors received LRA vs GA, whereas a larger fraction of patients with anatomic risk-factors received GA. Periprocedural clinical and technical adverse events did not differ by type of anesthesia. Intraprocedural performance metrics that drive procedural cost were similar between groups; potential differences in procedural cost driven by anesthetic choice require further study.

Indexed as

Anesthesia, ConductionAnesthesia, GeneralAnesthesia, LocalEndovascular ProceduresAgedAged, 80 and overFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeGeneral anesthesiaLocal/regional anesthesiaTranscarotid artery revascularization

Identifiers

PMID39179003
PMCPMC11585409

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.