Locoregional Versus General Anesthesia for Carotid Artery Stenting in the American College of Surgeons National Surgical Quality Improvement Project
Authors' conclusion
In patients undergoing CAS in the National Surgical Quality Improvement Program, GA was not associated with the composite outcome but was associated with increased rates of postoperative pneumonia and decreased rates of MI.
Study context
- Population
- All individuals undergoing carotid artery stenting (transfemoral or TCAR), American College of Surgeons NSQIP database 2011–2018754 (65.5%) locoregional
- Exposure
- Locoregional anaesthesia vs GA for carotid artery stenting
- Locoregionaln = 754reference
- Outcome
- Composite outcome:
- Stroke
- MI
- Death
Methodological detailsmultivariable analysis, propensity score-weighted analysis, registry database
- Multivariable analysis
- Propensity score-weighted analysis
- Registry database
Main finding
As reported in the abstract
- No difference in composite outcome (7.0% v 6.1%, p = 0.53); group order not stated
- Multivariable and propensity score-weighted analyses: no significant association of GA with composite outcome
Observational data: associations, not effects.
Further findings
| Outcome | OR | P value |
|---|---|---|
| MILower odds in GA group | 0.12 | P = 0.0362 |
| DeathHigher odds in GA group | 3.33 | P = 0.008 |
- Death: on multivariable analysis the risk of death appeared confounded by respiratory variables
Safety
| Outcome | OR | P value |
|---|---|---|
| Postoperative pneumoniaHigher odds in GA group | 3.87 | P = 0.0083 |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Locoregional Versus General Anesthesia for Carotid Artery Stenting in the American College of Surgeons National Surgical Quality Improvement Project. J Cardiothorac Vasc Anesth. Published 21 April 2024. doi:10.
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