Anesthetic management of endovascular procedures in patients with ischemic stroke

Background. Stroke is one of the main causes leading not only to mortality, but also severe disability even in timely access to medical care. Timely restoration of blood flow in ischemic brain area is essential in ischemic stroke. Over the past decade, active development of endovascular revascularization for ischemic stroke has improved the outcomes in these patients. There are still certain questions regarding the factors influencing the choice of general anesthesia and sedation in patients with ischemic strokes undergoing endovascular intervention. Objective. To assess the incidence of general combined anesthesia and sedation during endovascular interventions in patients with ischemic stroke, the influence of consciousness and verbal contact on the choice of anesthetic support for endovascular procedures, as well as the outcomes of disease after different methods of anesthetic support. Material and methods. A single-center retrospective observational study included 47 patients with ischemic strokes who underwent endovascular interventions under general anesthesia or sedation over a 1-year period. Results. General anesthesia and sedation was used in 42 (91%) and 4 (9%) patients, respectively. General anesthesia was accompanied by higher incidence of adverse outcomes. Conclusion. Preferable general anesthesia in patients with ischemic stroke undergoing endovascular interventions is due to lower level of consciousness and unavailable verbal communication. Higher incidence of adverse outcomes in patients undergoing general combined anesthesia is also associated with severity of ischemic stroke.