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Mechanical Thrombectomy for Acute Stroke

Anesthesia Implications

Clinically reviewed by anesthesia providers · Updated

Position : Supine, arms tucked
Time : 1-2 hours (average)
Blood Loss : Low (10-50 ml)
Post-op Pain : Minimal (0-3)
Maintenance Paralytic : Yes if general anesthesia is chosen, since movement during a run risks vessel injury; none under sedation.
Considerations : Off-site, Fluoroscopy / Xray, Arterial line, Aspiration risk / Full stomach

Anesthetic Approaches

1MAC, Conscious Sedation
2GETT, TIVA, Propofol Drip, Remifentanil Drip
The Surgery

Imaging and selection - noncontrast CT excludes hemorrhage, CT or MR angiography confirms the large vessel occlusion, and perfusion imaging judges salvageable tissue in later presentations. Access -...

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