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Updated: Jan 20, 2026
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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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Intravenous Propofol Versus Volatile Anesthetics For Stroke Endovascular Thrombectomy
William K Diprose1,2, Michael T M Wang1, Doug Campbell3
1Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland.
Journal of Neurosurgical Anesthesiology
|August 28, 2019
Summary
Propofol anesthesia may improve functional independence in ischemic stroke patients undergoing endovascular thrombectomy compared to volatile agents. Further randomized trials are needed to confirm these findings for anesthetic choice in stroke care.
Area of Science:
- Neurology
- Anesthesiology
- Cardiovascular Medicine
Background:
- Anesthetic technique choice for endovascular thrombectomy in ischemic stroke is debated.
- Intravenous propofol and volatile agents have distinct cerebral hemodynamic effects.
- These differences may impact brain tissue and patient outcomes.
Purpose of the Study:
- Compare outcomes of ischemic stroke patients undergoing endovascular thrombectomy under general anesthesia.
- Evaluate the differential effects of propofol versus volatile agents on clinical outcomes.
Main Methods:
- Retrospective analysis of consecutive endovascular thrombectomy patients receiving general anesthesia.
- Data collected on patient characteristics, anesthetic agent, and clinical outcomes.
- Functional independence at 3 months defined by modified Rankin Scale (0-2).
Main Results:
- 313 patients analyzed; 19% received propofol, 81% volatile agents (desflurane/sevoflurane).
- Propofol group had more comorbidities and severe strokes (higher NIHSS).
- Propofol associated with improved 3-month functional independence (OR 2.65, P=0.03) and a trend toward lower mortality.
Conclusions:
- Intravenous propofol may offer better outcomes than volatile agents in stroke patients undergoing endovascular thrombectomy.
- Findings are hypothesis-generating, suggesting a differential anesthetic effect.
- Randomized controlled trials are recommended to validate these results.
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