A hospital’s overall experience with general anaesthesia (GA) or conscious sedation (CS) may influence how choice of anaesthesia modality affects patient outcomes during mechanical thrombectomy, according to research presented at the 2026 Society of NeuroInterventional Surgery (SNIS) annual meeting (20–24 July, Seattle, USA).
These findings suggest that the effectiveness of an anaesthesia strategy depends not only on the technique itself, but also on the institutional protocols and experience supporting its use.
In the study, researchers analysed 9,036 thrombectomy procedures performed between 2020 and 2025 at 25 stroke centres participating in the Neurovascular Quality Initiative (NVQI) registry. These cases were reported from three CS-dominant centres, 17 GA-dominant centres, and five mixed-practice centres.
The researchers found that CS-dominant centres reported faster door-to-recanalisation times, higher first-pass effect (FPE) and lower in-hospital mortality, on average. Also, compared with CS-dominant centres, GA-dominant centres had nearly quadruple the intensive care unit (ICU) admission rate and double the median hospital length of stay.
However, the benefits of CS were observed only at centres where it was routinely used. At GA-dominant and mixed-practice centres, CS was not associated with lower mortality or faster reperfusion, leading the researchers to suggest that institutional experience may play an important role in patient outcomes.
“As neurointerventional techniques continue to advance, it’s equally important that we evaluate the practices that accompany them,” commented Joshua Feler (Brown University Health, Providence, USA), the study’s primary author. “Previous studies comparing GA and CS have produced mixed results. Our results suggest that differences in institutional experience may help explain those findings and highlight the importance of developing consistent protocols that support high-quality stroke care.”
The researchers further note that future trials should document and account for centre-level anaesthesia practice patterns when evaluating the effect of anaesthetic choice on outcomes.
