Endovascular Mx of acute ischemic stroke under GA: Predictor
The choice of anesthetic technique, general anesthesia (GA) versus Monitored Anesthesia Care, may impact the outcome of patients undergoing endovascular treatment of acute ischemic stroke (AIS).

The aim of this study, published in the Journal of Neurosurgical Anesthesiology was to identify the factors associated with good discharge outcome in patients receiving GA for AIS.

"These findings indicate the importance of ventilation management and extubation after endovascular intervention under GA in patients with AIS", the authors have concluded.

Electronic medical records of patients above 18 years old who underwent endovascular treatment of AIS under GA at a Comprehensive Stroke Center from 2010 to 2014 were reviewed. Good outcome was defined as discharge modified Rankin Score 0 to 2 and poor outcome as modified Rankin Score 3 to 6.

In total, 88 patients (56 males), aged 63 years with median National Institute of Health Stroke Scale (NIHSS) score 16 (range, 4 to 38) were included. Nineteen patients had good outcome and 78 had systolic blood pressure below the guideline-recommended 140 mm Hg under GA.

After adjusting for age and NIHSS score, the independent predictors of good discharge outcomes were higher maximum end-tidal carbon dioxide and extubation after endovascular treatment. A secondary analysis was performed after excluding 25 patients emergently intubated in the Emergency Department for airway protection. Postprocedure extubation was still associated with higher odds of good outcomes.

Read in detail about the study here: https://journals.lww.com/jnsa/Fulltext/2018/07000/Endovascular_Treatment_of_Acute_Ischemic_Stroke.5.aspx
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