Anesthetics management strategy for endovascular treatment of acute ischemic stroke. A proposal for anesthetic approach

Acute ischemic stroke is one of the leading causes of death and long-term disability for adults.

Endovascular therapy is the standard of care for severe acute ischemic stroke, caused by large-vessel occlusion in the anterior circulation; however, the optimal anaesthetic management during the procedure is still a matter of debate. The best anesthetic treatment should mainly be related to patients’ clinical conditions and the site of arterial occlusion. With this article, we share our experience based on the use of ketamine as the choosen hypnotic drug for general anesthesia, in order to avoid a sudden drop in blood pressure. The core of our proposal approach is the general anesthesia management by the medical emergency team with skills on both time-dependent diseases and neurocritical care.

Acute ischemic stroke; Anesthesia; Blood pressure; Endovascular trombectomy; Sedation; Neurocritical care

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