He added: “It is hard to know if this will change practice. As a rule, observational data should not drive change.”
Dr Goldstein noted that the policy at Duke at present is to use general anesthetic for these procedures. “Having people lie still is not the easiest.”
Dr Ovbiagele elaborated: “There are challenges of doing such interventional procedures in awake patients. If patients are lying still access is normally faster and if they can’t lie still, we have to use some sedation.”
Speculating on why general anesthesia may have an adverse effect, Dr Ovbiagele pointed out that general anesthesia tends to lower blood pressure. “We want to avoid this in acute stroke as the brain needs perfusion. In addition, there may be a time delay factor and a higher risk of pneumonia from intubation.”
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