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Master Thesis

Prise en charge anesthésique des thrombectomies mécaniques en neuroradiologie interventionnelle‎ : enquête nationale de pratiques‎

Abstract : Objectives: mechanical endovascular thrombectomy has become a major treatment of ischemic stroke. This procedure can be performed under general anesthesia, conscious sedation or local anesthesia. The literature evaluating the impact of anesthetic agents on the functional prognosis after mechanical thrombectomy finds conflicting results. Currently, no recommendation can be made. The objective of this work is the realization of an anesthetic practices survey in France during mechanical thrombectomy procedures. Study design: this is a practice survey conducted between November 2018 and June 2019 using a standardized questionnaire, among 37 French centers with interventional neuroradiology activities. The data collected were on the anesthetic method used, the type of anesthetic drugs used and the monitoring performed. Results: thirty-six centers participated. In 32 centers (89%), the use of an anesthetic team was systematic. The systematic or very frequent use of general anesthesia was found for 10 centers (28%), compared to 19 centers (53%) for conscious sedations and 7 centers (19%) for local anesthesia. Nineteen centers (68%) have a systolic blood pressure target greater than 140 mmHg. A total of 17 establishments (47%) have changed their organization since 2015 in line with an increase in the number of thrombectomy. Conclusion: our main observation is the increasing role of anesthetists systematically present during the thrombectomies in the majority of centers and at the same time the decline of the general anesthesia who became a minority practice in 2018.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02476273
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Submitted on : Wednesday, February 12, 2020 - 3:40:38 PM
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Déborah Bourdon. Prise en charge anesthésique des thrombectomies mécaniques en neuroradiologie interventionnelle‎ : enquête nationale de pratiques‎. Médecine humaine et pathologie. 2019. ⟨dumas-02476273⟩

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