Sevoflurane vs. Propofol for General Anesthesia in Patients With Acute Ischemic Stroke Treated With Endovascular Therapy

Inclusion Criteria: * Age over 18 years. * Acute ischemic stroke within 24 hours from last time seen well, requiring emergency endovascular treatment, with or without prior thrombolysis. * Intracranial anterior circulation occlusion, including occlusions of the M1 or M2 segments of the middle cerebral artery and/or the terminal internal carotid artery (TICA). Tandem lesions involving extracranial segments of the internal carotid artery are also eligible. * Alberta Stroke Program Early CT Score (ASPECTS) ≥6 on baseline computed tomography (CT). * Pre-stroke modified Rankin Scale (mRS) score of 0-3. * Indication for general anesthesia at the start of the procedure (within 30 minutes from femoral puncture) due to patient confusion or lack of cooperation, technical difficulties, or the treating team's preference. * Ability to provide informed consent by the patient or by a family member/legal representative. Exclusion Criteria: * Hemorrhagic lesions on baseline CT. * Anterior cerebral artery (ACA) occlusion. * Posterior circulation occlusion, including vertebral, basilar, or posterior cerebral arteries (PCA). * Hemodynamic instability. * Acute respiratory failure requiring orotracheal intubation. * General anesthesia required because of complications during endovascular treatment. * Known hypersensitivity to propofol, sevoflurane, or any of their excipients. * Personal or family history of malignant hyperthermia, or suspected susceptibility to malignant hyperthermia. * History of a previous serious adverse reaction to halogenated anesthetics, including hepatotoxicity associated with their use.