Stroke thrombectomy perioperative anesthetic and hemodynamic management

J Neurointerv Surg. 2023 May;15(5):483-487. doi: 10.1136/neurintsurg-2021-018300. Epub 2022 Jun 13.

Abstract

There is an ongoing debate about the optimal anesthetic and hemodynamic management of acute stoke patients with large vessel occlusion undergoing endovascular mechanical thrombectomy. Several prospective and retrospective analyses, and randomized controlled trials, attempted to address the challenges of using different anesthetic modalities in acute stroke patients requiring mechanical thrombectomy. We review the advantages and disadvantages of monitored anesthesia care, local anesthesia, conscious sedation, and general anesthesia, along with the relevance of hemodynamic management and perioperative oxygenation status in these complex patients.

Keywords: Blood Pressure; Drug; Intervention; Stroke; Thrombectomy.

Publication types

  • Review

MeSH terms

  • Anesthesia, General
  • Anesthetics*
  • Brain Ischemia* / surgery
  • Conscious Sedation
  • Endovascular Procedures*
  • Hemodynamics
  • Humans
  • Prospective Studies
  • Retrospective Studies
  • Stroke* / diagnostic imaging
  • Stroke* / surgery
  • Thrombectomy
  • Treatment Outcome

Substances

  • Anesthetics