Intraoperative management of thrombectomy for acute ischemic stroke: Do we need general anesthesia?

Shaun E. Gruenbaum, Benjamin F. Gruenbaum, Raphael A.O. Bertasi, Tais G.O. Bertasi, Alexander Zlotnik

Research output: Contribution to journalReview articlepeer-review

Abstract

Since 2015, endovascular thrombectomy has been established as the standard of care for re-establishing cerebral blood flow in patients with acute ischemic stroke. Several retrospective observational studies and prospective clinical trials have investigated two anesthetic techniques for endovascular stroke therapy: general anesthesia (GA) and conscious sedation (CS). The recent randomized studies suggest that GA is associated with higher rates of successful recanalization and better functional independence at 3 months compared with the CS technique. However, CS techniques are highly variable, and there is currently a lack of consensus on which anesthetic approach is best in all patients. Numerous patient and procedural factors should ultimately guide the decision of whether GA or CS should be used for a particular patient.

Original languageEnglish
Pages (from-to)171-179
Number of pages9
JournalBest Practice and Research: Clinical Anaesthesiology
Volume35
Issue number2
DOIs
StatePublished - 1 Jul 2021

Keywords

  • acute ischemic stroke
  • anesthesia management
  • endovascular stroke therapy

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