Stroke is a leading cause of death and disability, and is associated with a huge societal and economic burden. Interventions for the immediate treatment of ischaemic stroke due to large vessel occlusion are dependent on recanalisation of the occluded vessel. Trials have provided evidence supporting the efficacy of mechanical thrombectomy in ischaemic stroke due to large vessel occlusion. This has resulted in changes in management and organisation of stroke care worldwide. Major determinants of effectiveness of thrombectomy include: time between stroke onset and reperfusion; location of occlusion and local collateral perfusion; adequacy of reperfusion; patient age; and stroke severity. The role of anaesthetic technique on outcome remains controversial with published research showing conflicting results. As a result, choice of conscious sedation or general anaesthesia for mechanical thrombectomy is often dependent on individual operator choice or institutional preference. More recent randomised controlled trials have suggested that protocol-driven general anaesthesia is no worse than conscious sedation and may even be associated with better outcomes. These and other studies have highlighted the importance of optimal blood pressure management as a major determinant of patient outcome. Anaesthetic management should be tailored to the individual patient and circumstances. Acute ischaemic stroke is a neurological emergency; clinicians should focus on minimising door-to-groin puncture time and the provision of high-quality periprocedural care with a particular emphasis on the maintenance of an adequate blood pressure.

中文翻译：

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机械血栓切除术的麻醉：叙述性回顾。

中风是导致死亡和残疾的主要原因，并与巨大的社会和经济负担有关。因大血管闭塞而立即治疗缺血性卒中的干预措施取决于闭塞血管的再通。试验提供的证据支持机械血栓切除术对大血管闭塞引起的缺血性卒中的疗效。这导致全球中风护理的管理和组织发生了变化。血栓切除术有效性的主要决定因素包括：卒中发作和再灌注之间的时间；闭塞位置和局部侧支灌注；再灌注的充分性；患者年龄；和中风严重程度。麻醉技术对结果的作用仍然存在争议，已发表的研究显示相互矛盾的结果。因此，对于机械取栓术，选择清醒镇静或全身麻醉通常取决于个体操作者的选择或机构偏好。最近的随机对照试验表明，协议驱动的全身麻醉并不比清醒镇静差，甚至可能与更好的结果相关。这些和其他研究强调了最佳血压管理作为患者预后的主要决定因素的重要性。麻醉管理应针对个体患者和情况进行调整。急性缺血性中风是一种神经急症；临床医生应专注于最大限度地减少门到腹股沟穿刺时间和提供高质量的围手术期护理，特别强调维持足够的血压。