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Abstract Details

General Anesthesia for Thrombectomy in Ischemic Stroke Leads to Poor Outcomes as Compared to Conscious Sedation
Cerebrovascular Disease and Interventional Neurology
P1 - Poster Session 1 (5:30 PM-6:30 PM)
3-016
To determine whether the type of anesthesia used during endovascular recanalization has an effect on patient outcomes.
Recent trials have shown benefit of thrombectomy in patients with large vessel occlusion (LVO) ischemic stroke. Peri-procedural sedation and airway options are an unresolved issue with conflicting data. We sought to evaluate if conscious sedation (CS) is superior to general anesthesia (GA) for functional outcomes in patients undergoing thrombectomy for LVO.
We retrospectively analyzed data of consecutive patients who underwent thrombectomy in a single center cohort. Demographics, National Institute of Health Stroke Scale (NIHSS), vessel occlusion site, door to skin puncture time in minutes (min), core infarct volume on initial CTP, recanalization (mTICI IIb/III) rates, final infarct volume in milliliters (mL) and modified rankin scale (mRS) at 90 days were compared between patients who underwent thrombectomy with GA and CS.
We studied 137 patients of which 66 received GA and 71 received CS. Both groups (GA vs. CS) were balanced for age (p=0.67), initial core infarct volume (p=0.13) and intravenous thrombolysis (p=0.39). Patients who received CS had higher rate of favorable outcome (mRS 0-2; GA 18.2% vs. CS 46.5% p<0.001) at 90 days. Secondary outcomes of door to skin puncture (p<0.001) and final infarct volume (p=0.03) were favorable in patients who received CS. There was no difference in recanalization rates between the two groups (p=0.24). Shift analysis revealed favorable functional outcomes at 90 days with CS (p=0.003).

Patients receiving general anesthesia for thrombectomy have poor outcomes as compared to conscious sedation despite similar recanalization rates.  
Authors/Disclosures
Chantal Bhan, DO
PRESENTER 		Dr. Bhan has nothing to disclose.
Muhib Khan, MD, FAAN (Mayo Clinic) The institution of Dr. Khan has received research support from Mayo Clinic 好色先生 Grant . The institution of Dr. Khan has received research support from Mayo Clinic Small Grants .
Lee Elisevich No disclosure on file
Tracy J. Koehler Tracy J. Koehler has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
Bassel Raad, MD (Advent Health) No disclosure on file
Joseph Zachariah, DO (Spectrum Health) Dr. Zachariah has nothing to disclose.
Elysia James, MD (University of Toledo) Dr. James has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
Jiangyong Min, MD (Corewell Health West) Dr. Min has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic . Dr. Min has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for CredentialMed, LLC. The institution of Dr. Min has received research support from Corerwell Health Foundation .
Tamer Abdelhak, MD (Albany Medical College) Dr. Abdelhak has nothing to disclose.