The Ideal Sedation for Stroke Thrombectomy (ISST) registry will answer the key questions whether sedation with intubation and paralytics is feasible and whether it delays the time to recanalization in comparison with conscious sedation alone. As a pilot registry, it is anticipated to enroll 40 acute stroke patients requiring mechanical thrombectomy over 12-18 months. Following enrollment, data will be collected prospectively from medical records and from patients' visits.

Inclusion Criteria:

• Age ≥ 18 years
• Suitable for intra-arterial treatment for acute stroke up to 8 hours from onset of symptoms
• Clinical equipoise for best mode of sedation

Exclusion Criteria:

• Any known allergy to either proposed medication and its alternative
• Any patient that has been intubated prior to randomization
• Posterior circulation strokes
• Age ≤ 18
• Pregnant female

Patients underwent mechanical thrombectomy at Los Robles hospital, Thousand Oaks, CA