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New research · Anesthesiology
Neurology · 1d
Meta-analysisNeurology · 2026

General Anesthesia Versus Non-GA in Endovascular Therapy for Acute Ischemic Stroke: A Systematic Review and Bayesian Meta-Analysis of RCTs.

Philip Heesen, Olga Ciobanu-Caraus, Karam Azem … Martin Bendszus
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AnesthesiologyMeta-analysis

General anesthesia is associated with improved functional independence after endovascular therapy for stroke.

General Anesthesia Versus Non-GA in Endovascular Therapy for Acute Ischemic Stroke: A Systematic Review and Bayesian Meta-Analysis of RCTs.

Philip Heesen et al. · Neurology · 2026
Background

Endovascular thrombectomy (EVT) improves outcome in acute ischemic stroke (AIS) due to large vessel occlusion, yet the optimal anesthetic strategy remains controversial.

Purpose

We aimed to update the existing systematic review and to re-examine the cumulative randomized evidence using Bayesian statistical methods.

Methods

We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines.

n = 1,601
Results

general anesthesia is associated with a higher chance of living independently after stroke

OR 1.24 (95% CI 0.94 to 1.66)
null 1
0.94
1.66
CI crosses the null - not significant
More results

GA was associated with higher successful reperfusion rates (OR 1.73, 95% CrI 1.23-2.43; P (superiority) > 99%).

More results

No substantial differences were observed for 90-day mortality (OR 0.92, 95% CrI 0.67-1.27; P [superiority] 69%), excellent functional outcome (mRS 0-1; OR 1.06, 95% CrI 0.80-1.41; P [superiority] 67%), or symptomatic intracranial hemorrhage (OR 0.93, 95% CrI 0.56-1.52; P [superiority] 62%).

“
Conclusion

They suggest that GA may be preferred but confirmatory evidence is needed.

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