Anesthesiological support of mechanical thrombectomy: a review of current trends and approaches

Abstract

Despite the proven effectiveness of mechanical thrombectomy (MT) in treating ischemic stroke, this method has not yet gained standard status in Ukraine. The key factor for its successful implementation is creating appropriate conditions within the medical system, ensuring accessibility, and proper qualification of medical personnel. The development of a multidisciplinary approach to stroke treatment and consideration of the latest advancements in this field can contribute to providing the highest level of medical care for patients with this serious condition. An anesthesiologist plays an indispensable and critically important role during MT. Therefore, the objective of study ‒ to assess the role of anesthesiologist in the perioperative period of treating patients with ischemic stroke using MT, focusing primarily on global trends and modern approaches to anesthesia provision for this procedure. Literature data regarding the choice of the most effective anesthesia method during MT were analyzed. A review of hemodynamic monitoring parameters and key aspects of intraoperative and postoperative blood pressure correction, along with the impact of blood oxygen levels on neurological outcomes and mortality in patients with ischemic stroke after MT, was conducted. The study also considered prospects for the development of new approaches in treating this pathology, including the use of neuroprotective agents and therapeutic regional hypothermia in combination with anesthesia methods to improve patient outcomes. A thorough analysis of literature sources led to the conclusion that the deep knowledge, attention to detail, and professionalism of anesthesiologists help minimize risks and ensure optimal MT effectiveness, facilitating rapid patient recovery. From preoperative assessment to postoperative care, the anesthesiologist makes a significant contribution at every stage, creating optimal conditions for successful intervention and minimizing the risk of complications. Understanding the importance of the anesthesiologist's role and their active participation in MT can enhance the effectiveness of this technique and improve stroke treatment outcomes.