General Anesthesia Versus Non-GA in Endovascular Therapy for Acute Ischemic Stroke: A Systematic Review and…

Meta-analysisNeurology· Aug 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

Sedation & Anesthetic PharmacologyMeta-analysisTreatmentQ1IF 3.8

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 … Martin Bendszus

Neurology · Aug 2026

Background

Endovascular thrombectomy (endovascular thrombectomy) improves outcome in acute ischemic stroke (acute ischemic stroke) 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

General anesthesia 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%).

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Conclusion

These findings should be interpreted considering open-label designs and heterogeneous non-general anesthesia comparators.

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

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

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