BACKGROUND AND PURPOSE: General anesthesia (GA) for endovascular therapy (EVT) of acute @entity385 may be associated with worse outcomes. METHODS: The Interventional Management of @entity64 III trial randomized @entity1 within 3 hours of acute @entity385 onset to intravenous tissue-type plasminogen activator  EVT. GA use within 7 hours of @entity64 onset was recorded per protocol. Good outcome was defined as 90-day modified Rankin Scale  <=2. A multivariable analysis adjusting for dichotomized National Institutes of Health @entity64 Scale (NIHSS; 8-19 versus >= 20), age, and time from onset to groin puncture was performed. RESULTS: Four hundred thirty-four @entity1 were randomized to EVT, 269 (62%) were treated under local anesthesia and 147 (33.9%) under GA; 18 (4%) were undetermined. The 2 groups were comparable except for median baseline NIHSS (16 local anesthesia versus 18 GA; P<0.0001). The GA group was less likely to achieve a good outcome (adjusted relative risk, 0.68; confidence interval, 0.52-0.90; P=0.0056) and had increased in-hospital mortality (adjusted relative risk, 2.84; confidence interval, 1.65-4.91; P=0.0002). Those with medically indicated GA had worse outcomes (adjusted relative risk, 0.49; confidence interval, 0.30-0.81; P=0.005) and increased mortality (relative risk, 3.93; confidence interval, 2.18-7.10; P<0.0001) with a trend for higher mortality with routine GA. There was no significant difference in the adjusted risks of @entity510 (P=0.32) or symptomatic @entity1779 (P=0.37). CONCLUSIONS: GA was associated with worse neurological outcomes and increased mortality in the EVT arm; this was primarily true among @entity1 with medical indications for GA. Relative risk estimates, though not statistically significant, suggest reduced risk for @entity510 and symptomatic @entity1779 under local anesthesia. Although the reasons for these associations are not clear, these data support the use of local anesthesia when possible during EVT. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00359424.

Impact of General Anesthesia on Safety and Outcomes in the Endovascular Arm of Interventional Management of XXXX (IMS) III Trial.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke', 'Stroke'] @entity510 :: ('MESH:D013345', 'Disease') :: ['subarachnoid hemorrhage'] @entity1779 :: ('MESH:D002543', 'Disease') :: ['intracerebral hemorrhage'] @entity385 :: ('MESH:D002544', 'Disease') :: ['ischemic stroke']
@entity64 :: (MESH:D020521,Disease) :: ['Stroke']
