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  • Impact of anesthetic strategy on outcomes for patients with acute basilar artery occlusion undergoing mechanical thrombectomy

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Ischemic stroke
Original research
Impact of anesthetic strategy on outcomes for patients with acute basilar artery occlusion undergoing mechanical thrombectomy
  1. Fengli Li1,
  2. Junfang Wan2,
  3. Jiaxing Song1,
  4. Junjie Yuan1,
  5. Weilin Kong1,
  6. Jiacheng Huang1,
  7. Weidong Luo1,
  8. Deping Wu1,
  9. Linyu Li1,
  10. Luming Chen1,
  11. Chenghao Zhao1,
  12. Jin Chen3,
  13. Hui Tao2,
  14. Hongfei Sang1,
  15. Zhongming Qiu1,4,
  16. Wenjie Zi1,
  17. Qingwu Yang1,
  18. Xingyu Chen5,
  19. Hong Li2,
  20. Feng Peng5
  1. 1 Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
  2. 2 Department of Anesthesiology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
  3. 3 Department of Quality Control Office, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
  4. 4 Department of Neurology, 903th Hospital of PLA, Hangzhou, Zhejiang, China
  5. 5 Department of Neurology, Zhongshan Hospital Xiamen University, Xiamen, Fujian, China
  1. Correspondence to Dr Feng Peng, Department of Neurology, Zhongshan Hospital Xiamen University, Xiamen 361004, China; ppfeng{at}xmu.edu.cn; Dr Hong Li, Department of Anesthesiology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Lh78553{at}126.com

Abstract

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.

  • stroke
  • thrombolysis
  • intervention

Data availability statement

The data are available upon reasonable request.

https://doi.org/10.1136/neurintsurg-2021-018000

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    Data availability statement

    The data are available upon reasonable request.

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    Footnotes

    • 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.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.