{
  "abstract": "Introduction The optimal anesthesia strategy for mechanical thrombectomy (MT) in patients with large-core infarcts remains unclear. While general anesthesia (GA) ensures airway protection and patient immobility, conscious sedation (CS) allows for faster treatment initiation and intra-procedural monitoring. This post-hoc subanalysis of the TENSION trial investigates the effect of anesthesia strategy on outcomes after MT in this high-risk population.Aim of Study To compare early neurological improvement, functional outcome, procedural success, and safety between GA and CS in patients with large infarcts undergoing MT.Method We analyzed 117 patients from the interventional arm of the TENSION trial treated with MT under GA (n=50) or CS (n=67). Primary outcome was NIHSS improvement at 24 hours. Secondary outcomes included 90-day modified Rankin Scale (mRS), reperfusion success (eTICI 2b/3), procedural times, and safety events. Group comparisons were made using appropriate statistical tests.Abstract A60 Figure 1Results NIHSS improvement at 24 hours was more frequent in the CS group (79.1% vs. 58.0%, p=0.016), while early neurological worsening occurred more often in the GA group (34.0% vs. 14.9%, p=0.025). There were no significant differences in successful reperfusion (66.0% GA vs. 61.2% CS, p=0.69) or median 90-day mRS (5 vs. 4, p=0.55), though a trend toward favorable outcome (mRS 0–3) was observed with CS (36.0% vs. 24.0%, p=0.057). Safety profiles were comparable.Conclusion Conscious sedation was associated with better early neurological recovery without compromising procedural or safety outcomes. These findings support CS as a feasible anesthesia strategy for MT in patients with large infarcts, warranting further prospective evaluation.Conflict of Interest No",
  "authors": [
    {
      "affiliations": [
        "Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany"
      ],
      "name": "Sophia Hohenstatt"
    },
    {
      "affiliations": [
        "Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany"
      ],
      "name": "Markus Moehlenbruch"
    },
    {
      "affiliations": [
        "Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany"
      ],
      "name": "Dominik Vollherbst"
    }
  ],
  "title": "A60 Anesthesia strategy for mechanical thrombectomy in patients with large infarcts: a post-hoc subanalysis of the TENSION trial",
  "uid": "c3a9cc5c-52ab-5523-9543-dd6a8d560301"
}