600
Results, primary outcome
500
400
300
General
anesthesia,
n=65
10.5 (2.4-23.6)
Median acute
infarct (ml)
Median final
22.3 (8.1-64.5)
infarct (ml)
Median infarct 8.2 (2.2-38.6)
growth (ml)
Conscious
p-value
sedation, n=63
200
100
13.3 (5.2-31.1)
0.26
0
38.0 (16.7128.0)
19.4 (2.4-79.0)
0.04
-100
0.10
Infarct growth
Infarct growth
General anesthesia Conscious sedation
Results, secondary outcome
90 day mRS
Conscious sedation
11%
General anesthesia
22%
19%
18%
0%
10%
13%
29%
20%
mRS 0
30%
mRS 1
20%
40%
mRS 2
mRS 3
50%
mRS 4
60%
mRS 5
OR of lower mRS for patients treated with GA = 1.91 (95% 1.03-3.56)
16%
6%
12%
11%
70%
mRS 6
80%
13%
2%
90%
8%
100%
Conclusion
• EVT under GA does not result in worse outcomes
• In GOLIATH, signal of benefit appears to benefit GA
• Consistent across primary and multiple secondary endpoints
• Similar to results of SIESTA
• Future directions
• Pooled subgroup analyses to assess procedural and physiologic factors that
may contribute to good outcome