The impact of anesthesia choice during thrombectomy for distal and medium vessel occlusions: A systematic review and meta-analysis.
Ahmed Alkhiri, Fahad N Alrajban, Asayel A Alghamdi et al.
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In 30 seconds
This systematic review and meta-analysis compared general anesthesia (GA) with non-GA approaches during endovascular thrombectomy for distal and medium vessel occlusions. Six studies included 3019 patients, of whom 883 (29.2%) received GA. Good functional outcome at 90 days did not differ significantly between groups (modified Rankin Scale 0–2; OR, 0.97 [95% CI, 0.72–1.30]; p = 0.83), and recanalization and procedural complications were similar. GA was associated with higher 90-day mortality (OR, 1.98 [95% CI, 1.43–2.72]; p < 0.01).
Key findings
- Good 90-day functional outcome was similar with GA and non-GA (OR, 0.97 [95% CI, 0.72–1.30]; p = 0.83).
- Recanalization metrics and procedural complications were similar between anesthesia groups.
- GA was associated with higher 90-day mortality (OR, 1.98 [95% CI, 1.43–2.72]; p < 0.01).
Why it matters
Anesthesia choice is a practical consideration during thrombectomy for distal and medium vessel occlusions, where procedural access may be challenging. These pooled findings suggest comparable functional outcomes and procedural measures across approaches, alongside an association between GA and higher mortality. Interpreting that association cautiously is important because the evidence synthesis does not establish that GA caused the difference.
What to keep in mind
The review included six studies, and the abstract does not establish that the underlying comparisons were randomized. The authors state that additional robust evidence is needed to validate the findings and assess their significance across DMVO subgroups.