General Versus Non-General Anesthesia in Endovascular Thrombectomy for Distal/Medium Vessel Occlusions: A Systematic Review and Meta-Analysis.

Publication/Presentation Date

6-1-2026

Abstract

PURPOSE: With the expanding use of endovascular thrombectomy (EVT) for distal and medium vessel occlusions (DMVOs), evaluating how anesthesia type affects clinical outcomes is essential. This meta-analysis compared outcomes between general anesthesia (GA) and non-GA in patients undergoing EVT for DMVOs.

METHODS: We systematically searched PubMed, Embase, Cochrane Library, and Web of Science for eligible studies. Primary outcomes included successful reperfusion, 90-day mortality, excellent functional outcome (Modified Rankin Scale [mRS] 0-1), and symptomatic intracranial hemorrhage (sICH). Risk ratios (RR) with 95% confidence intervals (CI) were calculated using the Mantel-Haenszel method and a random-effects model. Heterogeneity was assessed with I

RESULTS: Five studies comprising 1643 patients were included. There was no significant difference in successful reperfusion between GA and non-GA groups (RR 1.01; 95% CI 0.94-1.08; I

CONCLUSION: GA was linked to increased 90-day mortality in EVT for DMVOs, with no differences in reperfusion or functional recovery. A possible higher risk of sICH was noted. Further prospective studies are needed to guide anesthetic strategy.

Volume

36

Issue

2

First Page

273

Last Page

284

ISSN

1869-1447

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

41288722

Department(s)

Administration and Leadership

Document Type

Article

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