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Comparison of sevoflurane and propofol for general anesthesia in patients with acute ischemic stroke undergoing mechanical thrombectomy

Verified siteRegistered drugNo placebo
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What is this trial about?

A plain-language summary of the goals, design and what participants do

This study investigates the use of different medications to maintain unconsciousness during medical procedures for patients experiencing an acute ischemic stroke, which is a type of brain attack caused by a blockage in a blood vessel. The goal is to compare two types of medicine used during general anesthesia, a state where a person is completely asleep and feels no pain during a procedure. The medicines being compared are sevoflurane, which is inhaled as a gas, and propofol, which is given through an intravenous injection into a vein. These medications will be used while patients undergo endovascular treatment, a procedure where doctors use thin tubes to reach and clear a blockage inside the blood vessels.

Participants in the study will be assigned to receive either the inhaled medicine or the injectable medicine. After the procedure is completed, the amount of brain tissue damage, known as cerebral infarction, will be measured. This measurement is performed using an MRI, which is a specialized imaging test that uses strong magnets to create detailed pictures of the inside of the body. The evaluation of the brain area affected by the stroke will take place approximately 72 hours after the treatment.

The research process

The trial runs in 2 steps – from screening to follow-up. Each step says what happens and what the team monitors.

  1. Step 1

    <b>anesthesia</b> administration

    During the mechanical thrombectomy, which is a procedure to remove a blood clot from an artery in the brain, one of two types of medication will be used to maintain general anesthesia (a state of controlled unconsciousness).

    You will receive either sevoflurane, which is an inhaled liquid used to produce vapor, at a concentration of 3%, or propofol, which is an injectable medicine administered through an intravenous line (directly into a vein) at a dose of 12 mg/kg/h.

  2. Step 2

    <b>imaging</b> follow-up

    Approximately 72 hours (plus or minus 24 hours) after the procedure, an MRI (magnetic resonance imaging, a type of medical scan) will be performed.

    This scan uses a specific technique called FLAIR to measure the final infarct volume, which refers to the size of the area of brain tissue damaged by the stroke.

Who can join the trial?

9 criteria

  • You must be older than 18 years of age.
  • You must have had an acute ischemic stroke, which is a sudden blockage of blood flow to the brain, within 24 hours of the last time you were seen acting normally.
  • You must be undergoing emergency endovascular treatment (EVT), which is a procedure where doctors use thin tubes to reach and clear a blockage inside your blood vessels.
  • The blockage must be in the anterior circulation, which refers to the main blood vessels that supply the front part of the brain.
  • This includes blockages in specific parts of the brain's arteries, such as the middle cerebral artery or the internal carotid artery.
  • Your initial computed tomography (CT) scan, which is a specialized X-ray that shows images of the brain, must show an Alberta Stroke Program Early CT Score (ASPECTS) of 6 or higher. This score helps doctors measure the extent of early damage from the stroke.
  • Your level of disability before the stroke, measured by the modified Rankin Scale (mRS), must be between 0 and 3. This scale measures how much a person's daily life is affected by their medical condition.
  • You must require general anesthesia, a state of controlled sleep where you do not feel pain, very shortly after the procedure begins. This may be due to confusion, difficulty with the medical procedure, or the doctor's preference.
  • You or a family member or legal representative must be able to provide informed consent, which means giving official permission to participate after understanding all the details of the study.

Who cannot join the trial?

9 criteria

  • Presence of hemorrhagic lesions, which means bleeding in the brain, seen on the initial CT scan (a special type of X-ray used to look at the brain).
  • Blockages in the anterior cerebral artery, which is a major blood vessel that supplies blood to the front part of the brain.
  • Blockages in the posterior circulation, which refers to the blood vessels that supply the back part of the brain, such as the vertebral, basilar, or posterior cerebral arteries.
  • Hemodynamic instability, which means that your blood pressure or heart rate is not steady or stable enough.
  • Acute respiratory failure, which is a sudden inability to breathe properly that requires a breathing tube placed through the mouth into the windpipe.
  • A decision to use general anesthesia (medicine that makes you sleep deeply during surgery) because of unexpected problems during the endovascular treatment (a procedure where doctors use thin tubes to treat blood vessels from inside the body).
  • A known hypersensitivity, or allergic reaction, to propofol, sevoflurane, or any of the inactive ingredients used to make these medicines.
  • A personal or family history of malignant hyperthermia, which is a rare and dangerous reaction to certain medicines that causes a very high body temperature, or a suspicion that you might be at risk for this condition.
  • A history of a previous severe reaction to halogenated anesthetics (a type of gas used for sleep during surgery), including hepatotoxicity, which is damage to the liver caused by these medicines.
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Investigated drugs

  • Sevoflurane

    is a gas that patients breathe in through a mask or tube to help them fall asleep and stay unconscious during a medical procedure.

  • Propofol

    is a medication given through a vein to help patients fall asleep and stay unconscious during a medical procedure.

What is already known about the treatment

  • Sevoflurane

    This medication is a liquid used for inhalation through a specialized breathing machine to help patients sleep during medical procedures. It is widely used in hospitals today as a standard agent for general anesthesia. This inhaled gas works by interacting with specific proteins in the brain to temporarily reduce nerve activity and prevent the sensation of pain or consciousness. It is classified as an inhalation anesthetic.

  • Propofol

    This medicine is administered as a liquid through an intravenous injection or a continuous infusion into a vein. It is a very common drug used in clinical practice to induce and maintain sleep during surgery or intensive care. It works by increasing the activity of a natural chemical in the brain that slows down nerve signals, effectively calming the central nervous system. It is classified as an intravenous sedative-hypnotic agent.

Investigated diseases

Acute ischemic stroke - This condition occurs when a blood vessel supplying blood to the brain becomes blocked by a clot. The interruption of blood flow prevents oxygen and essential nutrients from reaching brain cells. As a result, the affected brain tissue begins to suffer damage. This damage can lead to the death of brain cells in the specific area where the blockage occurred. The severity of the damage often depends on how quickly the blood flow is restored.
Trial detailsLast updated 7 Oct 2026
Age18+ yearsPhasePhase IIITrial ID2025-523709-13-00Protocol codeIIBSP-SAV-2025-178Estimated enrolment330 patientsSponsorFundacio Institut De Recerca De L'Hospital De La Santa Creu I Sant Pau

sourced from the EU Clinical Trials Register and site verification

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