Background The best anesthetic management strategy for patients with acute large vessel occlusion treated with mechanical thrombectomy (MT) remains uncertain. Most studies have focused on anterior–circulation stroke caused by large artery occlusion. Nevertheless, limited data are available on the appropriate choice of anesthetic for acute basilar artery occlusion (BAO). We aimed to investigate the effect of anesthetic method on clinical outcomes in patients with BAO undergoing MT.
Methods Patients undergoing MT for acute BAO in the BASILAR registry (Acute Basilar Artery Occlusion Study) were included. We divided patients into three groups according to the anesthetic technique used during MT: general anesthesia (GA), local anesthesia (LA), and conscious sedation (CS). Propensity score matching was performed to achieve baseline balance.
Results 639 patients were included. GA was used in 257 patients (40.2%), LA was used in 250 patients (39.1%), and CS was used in 132 patients (20.7%). After 1:1 matching, favorable outcome, mortality, and hemorrhagic transformation rates, as well as modified Rankin Scale (mRS) score at 90 days, did not differ between the GA, LA, and CS groups.
Conclusions The choice of anesthetic strategy, GA, LA, or CS, did not affect the clinical outcomes of patients with acute BAO treated with MT in the BASILAR registry.
Data availability statement
The data are available upon reasonable request.
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FL, JW and JS are joint first authors.
FL, JW and JS contributed equally.
Contributors FL, JW, and JS: study design and manuscript drafting. JY, WK, JH, WL, DW, LL, LC, CZ, JC, HT, and XC: key role in data acquisition, interpretation of the data, and revised the report. HS, ZQ, and WZ: statistical analyses. QY, HL, and FP: study design and revision of the draft paper. FP: Final approval of the version to be published and agreement to be accountable for all aspects of the work.
Funding This work was supported by the National Natural Science Foundation of China (No 82071323), Chongqing Natural Science Foundation (cstc2020jcyj-msxmX0926), Chongqing Science and Health Joint Project (No 2019ZDXM002), the Army Medical University Clinical Medical Research Talent Training Program (No 2018XLC3039, No 2019XLC2008, and No 2019XLC3016), and Medical and Health Planning Project of Xiamen (No 3502Z20209036).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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