Science Times: A Randomized Clinical Trial of Conscious Sedation vs General Anesthesia on Outcomes in Patients Receiving Thrombectomy for Ischemic Stroke

Stroke is a world-wide leading cause of morbidity and mortality.1,2 Pooled meta-analysis of 8 recent randomized clinical trials comprising 2423 patients demonstrated that patients were 1.71 times more likely to be functional independent at 3 mo if they received endovascular therapy.3 Subgroup meta-analysis of the 6 trials with large vessel occlusion (LVO) confirmation demonstrated even better functional outcomes.3

These trials have confirmed the significant benefit of endovascular therapy for ischemic stroke patients with LVO. These studies also highlighted the fact that faster recanalization times lead to improved outcomes. In a recent meta-analysis of pooled data from 1287 adults in 5 randomized clinical trials, thrombectomy up to 7.3 h after symptom onset was associated with improved outcomes.4 Rates of functional independence after thrombectomy were 64% with reperfusion at 3 h vs 46% with reperfusion at 8 h. For patients that received successful thrombectomy, every 1-h delay led to significant increase in disability.4

Full text available to all readers.