Accredited Section 3
Accreditation Period: 21 April 2022 - 20 April 2025

The purpose of this Continuing Professional Development module is to provide information pertaining to anesthetic considerations and management of endovascular thrombectomy (EVT) for patients with acute ischemic stroke.

Acute ischemic stroke is a devastating neurologic disorder and timely intervention is key to a good neurologic outcome. This article provides an overview of three important concepts: pathophysiology and disease characteristics of acute ischemic stroke, and the procedural and anesthetic aspects of EVT. Key considerations include recognition of stroke symptoms, timing and urgency of intervention, procedural considerations for anesthesiologists, risks and benefits of different anesthetic techniques, and a summary of recent guidelines. In particular, current recommendations for blood pressure management in this setting are reviewed.

Objectives of this Continuing Professional Development module:

After reading this module, the reader should be able to:

1. Describe the pathophysiology and sequelae of acute ischemic stroke;
2. Apply the current guidelines relevant to anesthetic management of patients presenting for endovascular thrombectomy;
3. Formulate an anesthetic plan for an individual patient presenting for endovascular thrombectomy based on the relative advantages and disadvantages of general anesthesia and sedation;
4. Prepare for the potential procedural complications of endovascular thrombectomy for stroke and appropriate anesthetic management.