OBJECTIVE The optimal anesthetic approach during endovascular therapy (EVT) in acute stroke patients remains an area of uncertainty. We investigated the impact of different anesthetic approaches on the outcome of posterior circulation stroke (PCS) patients undergoing EVT. METHODS For this observational study, we enrolled consecutive PCS patients who underwent EVT from December 2012 to December 2018, and compared functional outcomes at 90 days as well as long-term follow-up in patients treated under local anesthesia (LA) versus general anesthesia (GA). Multivariable logistic regression and propensity score matched analyses were conducted. RESULTS Among the 183 patients included in this study, 71 patients (38.8%) received LA and 112 patients (61.2%) received GA. Median modified Rankin Scale score at 90 days was 4 (IQR, 2-6) in both groups (P = .956). No significant differences in the rates of functional independence and mortality at 90 days as well as long-term follow-up post intervention were observed between the two groups, and Kaplan-Meier survival analysis showed comparable long-term survival probabilities. Safety outcomes (including procedure-related complications and serious adverse events) did not differ between these patients. The anesthetic approach was neither associated with functional independence nor associated with mortality. Propensity score matched analysis indicated similar results. CONCLUSIONS For PCS patients undergoing EVT, LA compared with GA does not seem to result in different functional outcomes and complications rates.

中文翻译：

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急性后循环卒中血管内治疗中局部麻醉与全身麻醉的比较

目的 急性卒中患者血管内治疗 (EVT) 期间的最佳麻醉方法仍然是一个不确定的领域。我们调查了不同麻醉方法对接受 EVT 的后循环卒中 (PCS) 患者结果的影响。方法 在这项观察性研究中，我们连续招募了 2012 年 12 月至 2018 年 12 月接受 EVT 的 PCS 患者，并比较了局部麻醉 (LA) 与全身麻醉下治疗的患者 90 天的功能结果以及长期随访。 GA）。进行了多变量逻辑回归和倾向评分匹配分析。结果 在本研究纳入的 183 名患者中，71 名患者 (38.8%) 接受了 LA，112 名患者 (61.2%) 接受了 GA。两组的 90 天改良 Rankin 量表评分中位数均为 4（IQR，2-6）（P = .956）。两组之间的功能独立性和 90 天死亡率以及干预后的长期随访没有显着差异，Kaplan-Meier 生存分析显示可比的长期生存概率。这些患者之间的安全性结果（包括手术相关并发症和严重不良事件）没有差异。麻醉方法既不与功能独立相关，也不与死亡率相关。倾向得分匹配分析表明结果相似。结论 对于接受 EVT 的 PCS 患者，LA 与 GA 相比似乎不会导致不同的功能结果和并发症发生率。