In HERMES, 402 of 570 patients (71%) were successfully reperfused to TICI 2b/3.189 Earlier trials with less efficient devices showed lower recanalization rates, 1 factor in their inability to demonstrate benefit from the procedure (IMS III, 41%; MR RESCUE, 25%). See Tables XVII and XLV in online Data Supplement 1. Powers et al 2019 Guidelines for Management of AIS e375 It is reasonable to select an anesthetic technique during EVT for AIS on the basis of individualized assessment of patient risk factors, technical performance of the procedure, and other clinical characteristics. IIa B-R Recommendation revised from 2015 Endovascular. Conscious sedation (CS) was the anesthetic modality widely used during endovascular procedures for acute stroke in the recent endovascular trials (90.9% of ESCAPE, 63% of SWIFT PRIME) with no clear positive or negative impact on outcome. In MR CLEAN, post hoc analysis showed a 51% (95% CI, 31 86) decrease in treatment effect with general anesthesia (GA) compared with CS.198 In THRACE, 51 of 67 patients receiving GA and 43 of 69 patients receiving CS during acute stroke endovascular procedures achieved mTICI grade 2b/3 (P=0.059) with no impact on functional outcomes (35 of 67 patients with GA and 36 of 74 with CS had an mRS score of 0 2 at 90 days).109 Thirty-five of 67 patients with GA and 36 of 74 with CS during acute stroke endovascular procedures had mRS scores of 0 to 2 at 90 Although several retrospective studies suggest that GA for acute stroke endovascular procedures produces worsening of functional outcomes, the limited available prospective randomized data do not support this. Three small ( 150 participants each) single-center RCTs have compared GA with CS during acute stroke endovascular procedures. 