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February 26, 2026Journal of Neurosurgical Anesthesiology

Delaying surgery several months after ischemic stroke is linked to lower perioperative mortality and CV risk.

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Why the study?

Prior ischemic stroke increases perioperative morbidity and mortality, requiring a framework to weigh the benefits of delaying surgery against the risks of postponement.

Does increasing the interval between ischemic stroke and surgery reduce perioperative mortality and morbidity?

Population

5 major studies of the timing of surgery after ischemic stroke

Design

Focused review

Key result

Delaying surgery for several months after ischemic stroke reduces perioperative mortality, recurrent stroke, and cardiovascular event risks.

Authors

AAAdekemi N. AkanoABAndrew BowmanMWMatthew K. Whalin

Discussion

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Overview

May warrant postponement of elective surgery after ischemic stroke; leaves open optimal interval pending randomized trials.

Key Points

  • This review aims to evaluate the impact of surgery timing on complications following ischemic stroke.
  • Reviewed 5 major studies related to surgery timing after ischemic stroke.
  • Assessed perioperative mortality and morbidity rates.
  • Analyzed the relationship between the interval from stroke to surgery and complications.
  • Found that delaying surgery can reduce the risk of complications and adverse events.
  • Identified the highest risk period for complications occurring in the months post-stroke.
  • Developed a framework for scheduling surgery based on evidence from the studies analyzed.

Structured PICO

Does increasing the interval between ischemic stroke and surgery reduce perioperative mortality and morbidity?

P
Population
Patients with prior ischemic stroke requiring surgery (based on a review of 5 major studies)
I
Intervention
Increasing the interval between stroke and surgery
O
Outcome
Perioperative mortality and morbidity (including recurrent stroke and other major adverse cardiovascular events)hard clinical

Perioperative cardiovascular risks are highest in the months immediately following an ischemic stroke and decline over time, requiring a careful balance when scheduling surgery.

Cite This Study

Akano et al. (2026) studied this question. Delaying surgery for several months after ischemic stroke reduces perioperative mortality, recurrent stroke, and cardiovascular event risks.

synapsesocial.com/papers/699fe33695ddcd3a253e6df9https://doi.org/10.1097/ana.0000000000001097
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