ArticleBJA open2026
Anaesthesia-related complications after endovascular therapy for acute ischaemic stroke under general anaesthesia with early extubation: A single-centre retrospective cohort study.
Article in BJA open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The optimal anaesthetic strategy for endovascular therapy (EVT) in acute ischaemic stroke (AIS) remains debated. We evaluated the incidence of anaesthesia-related complications, their predictors, and the associated clinical outcomes of a standardised general anaesthesia (GA) protocol. Methods: We retrospectively analysed patients undergoing EVT for AIS under GA over a 4-yr period. Patients were classified as having a complicated or uncomplicated course based on anaesthesia-related complications within 24 h post-EVT, defined as transfer from the angiography suite to the intensive care unit (ICU), prolonged stay at the post anaesthesia care unit (PACU), PACU-to-ICU transfer, or ICU transfer from the stroke ward. Predictors of a complicated course were analysed. The primary outcome was complication incidence. Secondary outcomes were 3-month functional outcome (modified Rankin Scale [mRS] 0-2 Results: Of 734 patients, 133 (18%) experienced an anaesthesia-related complication and had a complicated course. Admission NIHSS, younger age, and posterior circulation occlusion were the strongest predictors. These patients had smaller 24-h NIHSS improvement (mean difference 5.4, 95% confidence interval [CI] 4.1-6.7), higher pneumonia risk (odd ratio [OR]: 2.72, 95% CI: 1.66-4.48), poorer functional outcomes (mRS: 3-6; OR: 3.65, 95% CI: 2.15-6.20), and higher mortality (OR: 4.20, 95% CI: 2.45-7.21) compared with those with an uncomplicated course. Conclusions: Complications occurred in 133 (18%) patients and were more frequent in those with higher NIHSS scores and posterior circulation occlusions. Patients with a complicated course had poorer functional outcomes at 3 months.
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