Study design and patients
vessel occlusion
DIRECT-MT was a multicenter phase III prospective randomized clinical trial with open-label treatment and blinded outcome assessment to determine whether direct mechanical thrombectomy (MT) was noninferior to combined intravenous thrombolysis plus MT in patients with AIS due to an anterior circulation large vessel occlusion treatable within 4.5 h after symptom onset. The trial design, patient inclusion and exclusion criteria, treatment protocol, and final results have been previously published [This subgroup analysis was performed based on the intention-to-treat population of DIRECT-MT trial. Patients with an anesthesia record were enrolled and divided into GA group and non-GA group by whether receiving treatment under GA plus mechanical ventilation or non-GA including local anesthesia and conscious sedation. The choice of GA or non-GA was at the discretion of the participating centers, and the data were prospectively recorded. Those who were converted from non-GA to GA during MT were scored as non-GA according to the intention-to-treat principle. The workflow time intervals including the anesthesia procedure were also recorded. This study was approved by hospital committees on ethics of medicine and the research board of all participating centers. The article of this study was prepared following CONSORT reporting guidelines.