Sedation versus general anaesthesia in endovascular therapy for anterior circulation acute ischaemic stroke: the multicentre randomised controlled AMETIS trial study protocol.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
13 09 2019
Historique:
entrez: 15 9 2019
pubmed: 15 9 2019
medline: 26 9 2020
Statut: epublish

Résumé

Endovascular thrombectomy is the standard of care for anterior circulation acute ischaemic stroke (AIS) secondary to emergent large vessel occlusion in patients who qualify. General anaesthesia (GA) or conscious sedation (CS) is usually required to ensure patient comfort and avoid agitation and movement during thrombectomy. However, the question of whether the use of GA or CS might influence functional outcome remains debated. Indeed, conflicting results exist between observational studies with better outcomes associated with CS and small monocentric randomised controlled trials favouring GA. Therefore, we aim to evaluate the effect of CS versus GA on functional outcome and periprocedural complications in endovascular mechanical thrombectomy for anterior circulation AIS. Anesthesia Management in Endovascular Therapy for Ischemic Stroke (AMETIS) trial is an investigator initiated, multicentre, prospective, randomised controlled, two-arm trial. AMETIS trial will randomise 270 patients with anterior circulation AIS in a 1:1 ratio, stratified by centre, National Institutes of Health Stroke Scale (≤15 or >15) and association of intravenous thrombolysis or not to receive either CS or GA. The primary outcome is a composite of functional independence at 3 months and absence of perioperative complication occurring by day 7 after endovascular therapy for anterior circulation AIS. Functional independence is defined as a modified Rankin Scale score of 0-2 by day 90. Perioperative complications are defined as intervention-associated arterial perforation or dissection, pneumonia or myocardial infarction or cardiogenic acute pulmonary oedema or malignant stroke evolution occurring by day 7. The AMETIS trial was approved by an independent ethics committee. Study began in august 2017. Results will be published in an international peer-reviewed medical journal. NCT03229148.

Identifiants

pubmed: 31519668
pii: bmjopen-2018-027561
doi: 10.1136/bmjopen-2018-027561
pmc: PMC6747652
doi:

Banques de données

ClinicalTrials.gov
['NCT03229148']

Types de publication

Clinical Trial Protocol Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e027561

Investigateurs

Kevin Lagarde (K)
Bernard Cosserant (B)
Thibault Cammas (T)
Julien Pascal (J)
Florian Grimaldi (F)
Christine Rolhion (C)
Dominique Morand (D)
Erwan Laroche (E)
Camille Boissy (C)
Romain Grobost (R)
Antoine Brandely (A)
Isabelle Langlade (I)
Danielle Saurel (D)
Laurent Vallet (L)
Nicolas Molinari (N)
Nathalie Bourgois (N)
Xavier Moisset (X)
Pierre Clavelou (P)
Nicolas Vitello (N)
Betty Jean (B)
Abderrahim Zerroug (A)
Ricardo Moreno (R)
Jean Gabrillargues (J)
Jean-François Payen (JF)
Mathieu Zuber (M)
Romain Pasqualotto (R)
Frédéric Clarencon (F)
Grégory Torkomian (G)
Valentine Battisti (V)
Lionel Bapteste (L)
Anisoara Gemanar (A)
Catherine Mottolese (C)
Roxane Silve (R)
Olivier Lavabre (O)
Elie Thomas (E)
Violaine Baranger (V)
Helene Braud (H)
Elisabeth Lenormand (E)
David Bernstein (D)
Marie Gilles-Baray (M)
Chrysanthi Papagiannaki (C)
Nicolas Bruder (N)
Camille Vaisse (C)
Michele Bertrandy (M)
Laure Doukhan (L)
Sophie Cataldi (S)
Valentine Verdier (V)
Didier Sanchez (D)
Jean-Claude Dumont (JC)
Thomas Geeraerts (T)
Francois Delort (F)
Fouad Marhar (F)
Elsa Tardif (E)
David Rousset (D)
Claire Larcher (C)
Louis Delamarre (L)
Charlotte Martin (C)
Diane Osinski (D)
Francois Gaussiat (F)
Olivier Fourcade (O)
Jean-François Albucher (JF)
Jean-Marc Olivot (JM)
Lionel Calviere (L)
Nicolas Raposo (N)
Alain Viguier (A)
Christophe Cognard (C)
Fabrice Bonneville (F)
Anne-Christine Januel (AC)
Philippe Tall (P)
Caterina Michelozzi (C)
Jean Darcourt (J)
Elodie Parry (E)
Sarah Surmont (S)
Laurie Parmentier (L)
Elsa Jozefowicz (E)
Apolline Kazemihru (A)
Hilde Henon (H)
Aureli Lafanechere (A)
Lois Henry (L)
Clément Magand (C)
Mohamed Aggour (M)
Anaele Pregny (A)
Marlene Bonnefoi (M)
Francesca Rapido (F)
Océane Garnier (O)
Kevin Chalard (K)
Vincent Costala (V)
Jérome Ridolfo (J)
Mokhtar Bouhaddjar (M)
Bénédicte Delye (B)
Anne-Francoise Hocquet (AF)
Julien Fendeleur (J)
Sandra Granson (S)
Anne Lelong (A)
Sonia Alamowitch (S)
Souad Fellous (S)

Informations de copyright

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Russell Chabanne (R)

Department of Perioperative Medicine, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France rchabanne@chu-clermontferrand.fr.

Charlotte Fernandez-Canal (C)

Department of Perioperative Medicine, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.

Vincent Degos (V)

Anesthésie et Neuro-Réanimation chirurgicale Babinski, Assistance Publique Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière, Paris, France.

Anne-Claire Lukaszewicz (AC)

Service d'Anesthésie Réanimation, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Lyon, France.

Lionel Velly (L)

Service d'Anesthésie Réanimation, Assistance Publique Hôpitaux de Marseille (AP-HM), Hôpital La Timone, Marseille, France.

Segolene Mrozek (S)

Anesthesiology and Critical Care Department, Centre Hospitalier Universitaire de Toulouse, Hôpital Pierre-Paul Riquet, Toulouse, France.

Pierre-François Perrigault (PF)

Service d'Anesthésie Réanimation, Pôle Neurosciences Tête et Cou, CHU de Montpellier, Montpellier, France.

Serge Molliex (S)

Departement Anesthésie Réanimation, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France.

Benoit Tavernier (B)

Pôle Anesthésie Réanimation, Centre Hospitalier Regional Universitaire de Lille, Lille, France.

Claire Dahyot-Fizelier (C)

Service d'Anesthésie Réanimation, CHU de Poitiers, Poitiers, France.

Franck Verdonk (F)

Département d'Anesthésie-Réanimation, Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Paris, France.

Elodie Caumon (E)

Department of Clinical Research and Innovation (DRCI), Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.

Aurélie Masgrau (A)

Department of Clinical Research and Innovation (DRCI), Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.

Marc Begard (M)

Department of Perioperative Medicine, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.

Emmanuel Chabert (E)

Department of Neuroradiology, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.

Anna Ferrier (A)

Department of Neurology, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.

Samir Jaber (S)

Anesthesia and Critical Care, Montpellier University Hospital, Montpellier, France.

Jean-Etienne Bazin (JE)

Department of Perioperative Medicine, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.

Bruno Pereira (B)

Biostatistics Unit of the Department of Clinical Research and Innovation (DRCI), University Hospital CHU Clermont-Ferrand, Clermont-Ferrand, France.

Emmanuel Futier (E)

Department of Perioperative Medicine, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.
Université Clermont Auvergne, GRED, CNRS, Inserm U1103, Clermont-Ferrand, France.

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