Multicentre ObseRvational Study in Posterior mecHanical thrombEctomy: conscioUs Sedation vs General aneSthesia

Study Overview
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Brief Summary
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The association of conscious sedation vs. general anesthesia in ischemic stroke with posterior circulation occlusions undergoing endovascular therapy, is istill unknown. No prospective or clinical trials have studied this effect on posterior circulation strokes. The choice of anesthetic regimen is ussually depending on local stroke-team protocols or neurointerventional preference. MORPHEUS Stroke Registry is a prospective multicentre observational study that investigates the association between anestheisa and functional outcome in patients with posterior circulation large vessel occlusion treated endovascularly.

Official Title
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Multicentre ObseRvational Study in Posterior mecHanical thrombEctomy: conscioUs Sedation vs General aneSthesia: MORPHEUS STROKE REGISTRY

Conditions
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Mechanical Thrombectomy, General Anesthesia, Conscious Sedation, Posterior Circulation

Intervention / Treatment
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* Procedure: Type of anesthesia choice


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subject aged ≥ 18 years Evidence of posterior arterial occlussion (basilar artery, intracranial vertebral artery and posterior cerebral artery) Patients eligible for mechanical thrombectomy Exclusion Criteria: Patient's refusal to participate Arterial recanalization prior to endovascular thrombectomy attempt Patient unable to present or be available for follow-up

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Conscious Sedation<br> | Procedure: Type of anesthesia choice<br>* Use of conscious sedation vs. general anesthesia<br>|
| General Anesthesia<br> | Procedure: Type of anesthesia choice<br>* Use of conscious sedation vs. general anesthesia<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional independence at 3 months | Rate of functional independence (modified Rankin Scale 0-2) at 3 months | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| First Pass Effect | Rate of complete successful recanalization (mTICI 2c-3) with one single pass of device | 1 day | 
| Mortality | Rate of mortality at 3 months | 3 months | 
| Successfull recanalization and complete recanalization according to endovascular technique | Rate of mTICI 3 and mTICI 2b-3 according to endovascular technique (contact aspiration, stentriever or combined) | 1 day, revascularization grade will be assessed | 
| Number of passes | Number of intracranial thrombectomy passes to achieve final reperfusion | 1 day, number of device passes will be assessed | 
| NIHSS at 24 hours | Rate of neurological status at 24 hours, dramatical neurological improvement after mechanical thrombectomy | 24 hours | 
| Type of anesthesic and outcome | Study of the type of anesthesic choice and complications, time of intubation and | 3 months | 
| Length of stentretriever and recanalization | Rates of FPE and succesful recanalization according to the length of stentretriever used | 1 day, stentretriever type will be assessed | 
| Arterial hypotension during anesthesic induction and outcome | Study of arterial hypotension during anesthesic induction and outcome | 3 months | 
| Bridging therapy and neurologial/functional outcomes | To study the association between bridging therapy and reperfussion rates, neurological status and funtional independence at 3 months. | 1 day, type of previous fibrinolytic use will be assessed |