• Alessandro De Cassai, Giulio Andreatta, Joseph-Domenico Gabrieli, Francesco Causin, Annalisa Boscolo, Paolo Navalesi, and Marina Munari.
• UOC Anesthesia and Intensive Care Unit, University Hospital of Padua, Padua, Italy. Electronic address: alessandro.decassai@aopd.veneto.it.
• World Neurosurg. 2020 Jul 1; 139: 179-181.

BackgroundManagement of acute ischemic stroke (AIS) has rapidly improved over the last 10 years, mostly because of the evidence supporting wide adoption of endovascular mechanical thrombectomy (EMT) as first-line therapy. The anesthetic management of patients during EMT and its impact on functional outcomes remain an open discussion. Currently, investigations have only been made to compare general anesthesia with endotracheal intubation (GA) versus conscious sedation (CS), and results are still a matter of debate.Case DescriptionWe present the case of a 79-year-old man that developed an AIS because of occlusion of the M2 segment of the right middle cerebral artery who was successfully managed with a general anesthesia with supraglottic airway device (GA-SAD) during EMT.ConclusionsGA-SAD is a novel anesthetic approach to AIS undergoing EMT which has not been yet widely explored. We discuss its advantages, pitfalls, and suggest how it might be a valid compromise between GA and CS in the management of AIS.Copyright © 2020 Elsevier Inc. All rights reserved.

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