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Society for Neuroscience in Anesthesiology and Critical Care Expert Consensus Statement: Anesthetic Management of Endovascular Treatment for Acute Ischemic Stroke*: Endorsed by the Society of NeuroInterventional Surgery and the Neurocritical Care Society

Talke, Pekka O. MD*; Sharma, Deepak MD, DM; Heyer, Eric J. MD, PhD; Bergese, Sergio D. MD§; Blackham, Kristine A. MD; Stevens, Robert D. MD

Journal of Neurosurgical Anesthesiology: April 2014 - Volume 26 - Issue 2 - p 95–108
doi: 10.1097/ANA.0000000000000042
Special Article

Literature on the anesthetic management of endovascular treatment of acute ischemic stroke (AIS) is limited. Anesthetic management during these procedures is still mostly dependent on individual or institutional preferences. Thus, the Society of Neuroscience in Anesthesiology and Critical Care (SNACC) created a task force to provide expert consensus recommendations on anesthetic management of endovascular treatment of AIS. The task force conducted a systematic literature review (up to August 2012). Because of the limited number of research articles relating to this subject, the task force solicited opinions from experts in this area. The task force created a draft consensus statement based on the available data. Classes of recommendations and levels of evidence were assigned to articles specifically addressing anesthetic management during endovascular treatment of stroke using the standard American Heart Association evidence rating scheme. The draft consensus statement was reviewed by the Task Force, SNACC Executive Committee and representatives of Society of NeuroInterventional Surgery (SNIS) and Neurocritical Care Society (NCS) reaching consensus on the final document. For this consensus statement the anesthetic management of endovascular treatment of AIS was subdivided into 12 topics. Each topic includes a summary of available data followed by recommendations. This consensus statement is intended for use by individuals involved in the care of patients with acute ischemic stroke, such as anesthesiologists, interventional neuroradiologists, neurologists, neurointensivists, and neurosurgeons.

*Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA

Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA

Departments of Anesthesiology and Neurology, Columbia University, New York, NY

§Departments of Anesthesiology and Neurological Surgery, The Ohio State University, Columbus (on behalf of Society for Neuroscience in Anesthesiology and Critical Care [SNACC])

Department of Radiology, Case Western Reserve University, Cleveland, OH (representing the Society of NeuroInterventional Surgery [SNIS])

Departments of Anesthesiology Critical Care Medicine, Neurology, Neurosurgery and Radiology, Hopkins University School of Medicine, Baltimore, MD (representing the Neurocritical Care Society [NCS])

* Society Consensus Statements published in the Journal of Neurosurgical Anesthesiology have been reviewed by the JNA Affiliate Societies that submit them for publication. They have not undergone review by the Editorial Board of the Journal of Neurosurgical Anesthesiology.

All the authors are supported by the University and Departmental funds.

The authors have no conflicts of interest to disclose.

Reprints: Pekka O. Talke, MD, Department of Anesthesia and Perioperative Care, University of California San Francisco, 521 Parnassus Avenue, C455, San Francisco, CA 94143 (e-mail: talkep@anesthesia.ucsf.edu).

Received December 17, 2013

Accepted December 17, 2013

© 2014 by Lippincott Williams & Wilkins