Choice of ANesthesia for EndoVAScular Treatment of Acute Ischemic Stroke (CANVAS): Results of the CANVAS Pilot Randomized Controlled Trial

Background: The effect of choice of anesthesia on clinical outcome for endovascular treatment (EVT) in patients with acute ischemic stroke (AIS) remains unclear. Methods: We conducted a pilot trial of 43 patients with acute anterior circulation ischemic stroke having EVT. Patients were randomly allocated to receive general anesthesia or conscious sedation. We documented the rate of recruitment and rate of conversion from conscious sedation to general anesthesia. In addition, we recorded the change in National Institute of Health stroke scale (NIHSS) on day 7, the rate of successful reperfusion and measured neurological function by certified researchers using modified Rankin Score (mRS 0 to 2) at 90 days. Results: The recruitment rate was 31.4% and majority of patients were excluded because of delay in hospital presentation and posterior circulation stroke. The rate of conversion from conscious sedation to general anesthesia was 18.2%. This was primarily related to excessive sedation and uncontrolled movement. Change in NIHSS score, rate of successful reperfusion and functional recovery were similar between groups. Conclusions: It was feasible to randomize AIS patients receiving either general anesthesia or conscious sedation for EVT. J.S. and F.L. contributed equally. Supported by the Beijing Municipal Administration of Hospitals Youth Program (code number: QML20150508), Ascent Plan (number: DFL20180502) Clinical Medicine Development of Special Funding Support (number: ZYLX201708) and China National key scientific research project (number: 2016YFC1301500). J.S., F.L., Y.P., Z.M., AW.G., M.T.V.C., and R.H.: helped with the study design and manuscript preparation. Y.P., and R.H.: equally contributed to the manuscript. J.S., F.L., Y.W., Y.Z., and Y.P.: involved in the data collection from neurosurgical anesthesia. L.Z. and Y.P.: helped with the data analyses. M.T.V.C. and R.H. are the members from the Editorial Board of Journal of Neurosurgical Anesthesiology. The remaining authors declare that they have nothing to disclose. Address correspondence to: Ruquan Han, MD, PhD, Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR China (e-mail: ruquan.han@ccmu.edu.cn). Received July 24, 2018 Accepted October 22, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved

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