Original Investigation

Sedation vs General Anesthesia for Endovascular Therapy in Acute Ischemic Stroke

JAMA Neurology 10.1001/jamaneurol.2025.3775

October 13, 2025 at 11:00 AM EDT

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Does mechanical thrombectomy under general anesthesia (GA) or moderate sedation result in different neurological outcomes in patients with large vessel occlusion acute ischemic stroke?This multicenter randomized clinical trial included 260 patients. Compared with moderate sedation, GA demonstrated higher odds of improved 90-day disability (primary outcome) and successful reperfusion.Patients with ischemic stroke treated with endovascular thrombectomy had less disability and a higher rate of successful reperfusion if treated using GA compared with those treated using moderate sedation.

Corresponding Author: Peng Roc Chen, MD, Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston, 6400 Fannin St, Ste 2800, Houston, TX 77030 (peng.r.chen@uth.tmc.edu).

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