Abstract Details

Title General Anesthesia for Thrombectomy in Extended Window Leads to Similar Outcomes as Compared to Conscious Sedation

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P9 - Poster Session 9 (12:00 PM-1:00 PM)

Poster/Presentation
Number 4-001

Objective

We sought to evaluate if conscious sedation (CS) is superior to general anesthesia (GA) for functional outcomes in patients undergoing extended window thrombectomy for large vessel occlusion (LVO).

Background Recent trials have shown benefit of thrombectomy in patients with LVO ischemic stroke in the extended window (6-24 hours). Periprocedural sedation and airway options are an unresolved issue with conflicting data.

Design/Methods We retrospectively analyzed data of consecutive patients who underwent thrombectomy in a single center cohort. Demographics, 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 extended window thrombectomy with GA and CS.

Results We studied 217 patients of which 85 patients underwent extended window thrombectomy; 36/85 received GA and 49/85 received CS. There were no significant (p>0.05) differences in clinical and demographic variables between the anesthesia groups. Logistic regression analysis showed that anesthesia type was not a predictor of favorable outcome (mRS 0-2) at 90 days (OR: 0.94, 95% CI: 0.25-3.6; p=0.93); final infarct volume was predictive (OR: 1.1, 95% CI: 1.0-1.2; p<0.001). Similar results were seen in a secondary analysis that included all 217 patients with final infarct volume being the only predictor of favorable outcome with no effect of anesthesia type or onset to skin puncture.

Conclusions Patients receiving general anesthesia for thrombectomy in extended window have similar outcomes as compared to conscious sedation.

Authors/Disclosures
Chantal Bhan, DO PRESENTER	Dr. Bhan has nothing to disclose.
Muhib Khan, MD, F�鶹��ýӳ�� (Mayo Clinic)	The institution of Dr. Khan has received research support from Mayo Clinic �鶹��ýӳ�� 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
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
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 .
Nabil Wees, MD (Augusta University)	Dr. Wees has nothing to disclose.
Nadeem I. Khan, MD (Spectrum Health)	Dr. Khan has nothing to disclose.

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