Supraglottic Airway Device in Acute Ischemic Stroke Undergoing Mechanical Thrombectomy: Is It Feasible?

Alessandro De Cassai; Giulio Andreatta; Joseph-Domenico Gabrieli; Francesco Causin; Annalisa Boscolo; Paolo Navalesi; Marina Munari

doi:10.1016/j.wneu.2020.04.044

Supraglottic Airway Device in Acute Ischemic Stroke Undergoing Mechanical Thrombectomy: Is It Feasible?

World Neurosurg. 2020 Jul:139:179-181. doi: 10.1016/j.wneu.2020.04.044. Epub 2020 Apr 18.

Authors

Alessandro De Cassai¹, Giulio Andreatta², Joseph-Domenico Gabrieli³, Francesco Causin³, Annalisa Boscolo⁴, Paolo Navalesi⁵, Marina Munari⁴

Affiliations

¹ UOC Anesthesia and Intensive Care Unit, University Hospital of Padua, Padua, Italy. Electronic address: alessandro.decassai@aopd.veneto.it.
² DIMED, Department of Medicine, University Hospital of Padua, Padua, Italy.
³ Neuroradiology Unit, University Hospital of Padua, Padua, Italy.
⁴ UOC Anesthesia and Intensive Care Unit, University Hospital of Padua, Padua, Italy.
⁵ UOC Anesthesia and Intensive Care Unit, University Hospital of Padua, Padua, Italy; DIMED, Department of Medicine, University Hospital of Padua, Padua, Italy.

PMID: 32311551
DOI: 10.1016/j.wneu.2020.04.044

Abstract

Background: Management of acute ischemic stroke (AIS) has rapidly improved over the last 10 years, mostly because of the evidence supporting wide adoption of endovascular mechanical thrombectomy (EMT) as first-line therapy. The anesthetic management of patients during EMT and its impact on functional outcomes remain an open discussion. Currently, investigations have only been made to compare general anesthesia with endotracheal intubation (GA) versus conscious sedation (CS), and results are still a matter of debate.

Case description: We present the case of a 79-year-old man that developed an AIS because of occlusion of the M2 segment of the right middle cerebral artery who was successfully managed with a general anesthesia with supraglottic airway device (GA-SAD) during EMT.

Conclusions: GA-SAD is a novel anesthetic approach to AIS undergoing EMT which has not been yet widely explored. We discuss its advantages, pitfalls, and suggest how it might be a valid compromise between GA and CS in the management of AIS.

Keywords: Case report; Laryngeal mask airway; Stroke; Supraglottic airway device; i-gel.

Publication types

Case Reports

MeSH terms

Aged
Airway Management / methods*
Anesthesia, General / methods*
Computed Tomography Angiography
Endovascular Procedures / methods*
Humans
Infarction, Middle Cerebral Artery / surgery*
Laryngeal Masks*
Male
Thrombectomy / methods*