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  • O-034 Influence of general anesthesia on outcomes after anterior circulation mechanical thrombectomy: results from the prospective international assist registry

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SNIS 21st annual meeting oral abstracts
O-034 Influence of general anesthesia on outcomes after anterior circulation mechanical thrombectomy: results from the prospective international assist registry
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  1. H Hoffman1,
  2. S Miralbés2,
  3. B Naravetla3,
  4. A Spiotta4,
  5. C Loehr5,
  6. M Martínez-Galdámez6,
  7. R McTaggart7,
  8. L Defreyne8,
  9. P Vega9,
  10. O Zaidat10,
  11. L Price11,
  12. D Liebeskind12,
  13. M Möhlenbruch13,
  14. R Gupta14,
  15. N Goyal1
  1. 1Semmes-Murphey, Memphis, TN
  2. 2Hospital Son Espases, Mallorca, Spain
  3. 3McLaren Regional Medical Center, Flint, MI
  4. 4Medical University of South Carolina, Charleston, SC
  5. 5Klinikum Vest Recklinghausen, Recklinghausen, GY
  6. 6Hospital Clínico Universitario de Valladolid, Valladolid, Spain
  7. 7Rhode Island Hospital, Providence, RI
  8. 8Ghent University Hospital, Gent, Belgium
  9. 9Hospital Universitario Central de Asturias-HUCA, Oviedo, Spain
  10. 10Bon Secours Mercy Health St. Vincent Medical Center, Toledo, OH
  11. 11Stryker Neurovascular, Salt Lake City, UT
  12. 12David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
  13. 13Uniklinik Heidelberg, Heidelberg, Germany
  14. 14WellStar Health System, Marietta, GA

Abstract

Introduction Multiple studies have evaluated whether general anesthesia (GA) improves outcomes after mechanical thrombectomy (MT) with mixed results. In addition, most have not evaluated procedural outcomes such as degree of recanalization and first pass recanalization.

Methods The ASSIST registry, a prospective, global, multicenter registry of patients with anterior circulation large vessel occlusion (LVO) undergoing mechanical thrombectomy was used. Patients with ICA or M1/2 occlusions ≥ 18 years old were included. The variable of interest was type of anesthesia used during MT, which was dichotomized to GA or non-GA (MAC, conscious sedation, and no anesthesia). The outcomes of interest were time from groin puncture to recanalization in patients who achieved eTICI ≥ 2b50 recanalization, final recanalization with eTICI ≥ 2c, first pass recanalization with eTICI ≥ 2c, intraprocedural complications, 90-day favorable outcome (mRS 0–2), sICH, any ICH, and early neurologic deterioration ([END] defined as an increase in NIHSS ≥ 4 points from baseline up to 48 hours after MT. Multivariable regression models were generated for each outcome.

Results A total of 1,477 patients who underwent MT with 38.9% under GA were included. In the multivariable analysis GA was not significantly associated with time from groin puncture to recanalization (p = 0.08) but was significantly associated with greater odds of final recanalization with eTICI ≥ 2c (OR 1.62, 95% CI 1.11 - 2.36 [table 1]). There was no significant difference in the odds of intraprocedural complications for the GA group (OR 0.73, 95% CI 0.28 - 1.92). GA was also not significantly associated with 90-day favo ERMAN rable outcome, sICH, any ICH, END, or first pass recanalization with eTICI ≥ 2c. In a subgroup analysis excluding patients who did not receive any form of sedation, GA was still significantly associated with greater odds of final recanalization with eTICI ≥ 2c (OR 1.65, 95% CI 1.12 - 2.44).

Conclusion GA for anterior circulation MT may be associated with greater odds of eTICI ≥ 2c final recanalization.

View this table:
Abstract O-034 Table 1

Regression for final reperfusion with eTICI ≥ 2c

Disclosures H. Hoffman: None. S. Miralbés: None. B. Naravetla: None. A. Spiotta: None. C. Loehr: None. M. Martínez-Galdámez: None. R. McTaggart: None. L. Defreyne: None. P. Vega: None. O. Zaidat: None. L. Price: None. D. Liebeskind: None. M. Möhlenbruch: None. R. Gupta: None. N. Goyal: None.

https://doi.org/10.1136/jnis-2024-SNIS.34

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