{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:30:52Z","timestamp":1783517452418,"version":"3.55.0"},"reference-count":45,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The optimal anesthetic strategy during mechanical thrombectomy (MT) for acute ischemic stroke (AIS) remains debated. Although randomized trials suggest broadly comparable outcomes between general anesthesia (GA) and conscious sedation (CS), real-world data may be influenced by baseline severity, airway management, and postprocedural complications. We evaluated associations between anesthetic strategy, functional outcomes, mortality, and infectious and hemorrhagic complications after MT. Methods: This retrospective observational study included 257 consecutive adults with AIS treated with MT at a single comprehensive stroke center. Patients were managed under CS or GA according to clinical and procedural considerations. Outcomes, mortality, infectious and hemorrhagic complications were compared between groups. Multivariable logistic regression assessed associations with 90-day functional independence and mortality, adjusting for baseline and procedural factors. In an exploratory GA subgroup analysis, outcomes were compared according to extubation timing, defined as early (\u22646 h) or delayed (&gt;6 h). Results: Of 257 patients, 155 (60.3%) underwent MT under CS and 102 (39.7%) under GA. GA-treated patients had higher baseline NIHSS scores and worse unadjusted functional outcomes throughout follow-up. After adjustment, GA remained associated with higher 90-day mortality (OR 4.39, 95% CI 1.50\u201312.84; p = 0.007) and lower odds of 90-day functional independence (OR 0.29, 95% CI 0.10\u20130.82; p = 0.020). Pneumonia was more frequent with GA (49.0% vs. 26.5%; p &lt; 0.001), although attenuated in adjusted analyses. Delayed extubation was associated with worse outcomes, higher pneumonia rates, and more frequent symptomatic intracranial hemorrhage. Conclusions: GA was associated with worse functional outcomes and higher mortality after MT, but residual confounding and differences in baseline stroke severity likely contributed to these associations. Pneumonia and hemorrhagic complications may identify patients at increased risk of poor outcome, especially when extubation is delayed. Findings require prospective confirmation.<\/jats:p>","DOI":"10.3390\/jcm15134993","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T08:45:20Z","timestamp":1782722720000},"page":"4993","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anesthetic Strategy, Functional Outcomes, and Infectious Complications After Mechanical Thrombectomy for Acute Ischemic Stroke"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0780-3186","authenticated-orcid":false,"given":"Aleksander","family":"D\u0119biec","sequence":"first","affiliation":[{"name":"Clinic of Neurology, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1246-7021","authenticated-orcid":false,"given":"Andrzej","family":"Micha\u0142owski","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Boniecka","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Warsaw, 02-089 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Winnicka","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Warsaw, 02-089 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bartosz","family":"Rustecki","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Zi\u0119cina","sequence":"additional","affiliation":[{"name":"Department of Radiology, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6856-111X","authenticated-orcid":false,"given":"Jerzy","family":"Narloch","sequence":"additional","affiliation":[{"name":"Department of Radiology, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3968-7463","authenticated-orcid":false,"given":"Piotr","family":"Piasecki","sequence":"additional","affiliation":[{"name":"Department of Radiology, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0214-4940","authenticated-orcid":false,"given":"Adam","family":"St\u0119pie\u0144","sequence":"additional","affiliation":[{"name":"Clinic of Neurology, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek","family":"Staszewski","sequence":"additional","affiliation":[{"name":"Clinic of Neurology, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1016\/S0140-6736(16)00163-X","article-title":"Endovascular thrombectomy after large-vessel ischaemic stroke: A meta-analysis of individual patient data from five randomised trials","volume":"387","author":"Goyal","year":"2016","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e344","DOI":"10.1161\/STR.0000000000000211","article-title":"Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke","volume":"50","author":"Powers","year":"2019","journal-title":"Stroke"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e8","DOI":"10.1136\/neurintsurg-2018-014569","article-title":"European Stroke Organisation (ESO)-European Society for Minimally Invasive Neurological Therapy (ESMINT) guidelines on mechanical thrombectomy in acute ischemic stroke","volume":"15","author":"Turc","year":"2023","journal-title":"J. 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