General anesthesia versus conscious sedation in mechanical thrombectomy for acute ischemic stroke

Abstract

Mechanical thrombectomy (MT) has become the standard care of treatment for eligible patients with large vessel occlusion (LVO) leading to acute ischemic stroke. In this study we review and compare compromise the outcome of general anesthesia (GA)and conscious sedation (CS) in mechanical thrombectomy This Study was conducted in Mashhad, Iran in 2018 and 2019.All patients with following criteria were included into study:acute ischemic stroke and large vessel occlusion. We compare procedural outcome, imaging outcome and clinical outcome between two groups of GA and CS. 114 patients were included into the study. Mean of age was 55.9±13.5 years (19-79). Mean of passage was 2.4±1.5 (1-8). MCA, ICA and vertebrobasilar artery occlusion were seen in 57 patients (50%), 49 patients (43%) and 8 patients (7%) respectively. 74 patients (64.9%) underwent CS and 40 patients (35.1%) GA for mechanical thrombectomy. In CS group, successful recanalization (TICI 2b or more) was 81% and in GA group successful recanalization was 65%. Despite better recanalization in GA group, the difference was not significant (p=0.057). Time interval between symptom onset and femoral puncture was 5.7 ± 2.5 for GA and 5.4 ± 2.2 hours for CS(p=0.639). Mean passage number in GA and CS was 2.4±1.4 and 2.3±1.6 respectively. The difference was not significant (p=0.753). Good outcome (mRs 0-2) was 46.3% in CS group and 40.7% in GA group (p=0.635). Our results showed type of Anesthesia (GA versus CS) do not significantly affect the time interval between symptoms onset and femoral puncture, passage number, successful recanalization, and clinical outcome of patients.