Back to Search Start Over

Impact of blood pressure levels within first 24 hours after mechanical thrombectomy on clinical outcome in acute ischemic stroke patients.

Impact of blood pressure levels within first 24 hours after mechanical thrombectomy on clinical outcome in acute ischemic stroke patients.

Authors :
Cernik, David
Sanak, Daniel
Divisova, Petra
Kocher, Martin
Cihlar, Filip
Zapletalova, Jana
Veverka, Tomas
Prcuchova, Andrea
Ospalik, Dusan
Cerna, Marie
Janousova, Petra
Kral, Michal
Dornak, Tomas
Prasil, Vojtech
Franc, David
Kanovsky, Petr
Source :
Journal of NeuroInterventional Surgery; Aug2019, Vol. 11 Issue 8, p735-739, 5p, 6 Charts
Publication Year :
2019

Abstract

Introduction Despite early management and technical success of mechanical thrombectomy (MT) for acute ischemic stroke (AIS), not all patients reach a good clinical outcome. Different factors may have an impact and we aimed to evaluate blood pressure (BP) levels in the first 24 hours after MT. Methods consecutive AIS patients treated with MT were enrolled in the retrospective bi-center study. Neurological deficit was assessed with National Institutes of Health Stroke Scale (NIHSS) and functional outcome after 3 months with modified Rankin scale (mRS) with a score 0-2 for good outcome. The presence of symptomatic intracerebral hemorrhage (SICH) was assessed according to the SITS-MOST criteria. results Of 703 treated patients, completed BP levels were collected in 690 patients (350 males, mean age 71±13 years) with median of admission NIHSS 17 points. Patients with mRS 0-2 had a lower median of systolic BP (SBP) compared with those with poor outcome (131 vs 140 mm Hg, P<0.0001). The rate of SICH did not differ between the patients with a median of SBP <140 mm Hg and ≥140 mm Hg. (5.1% vs 5.1%, P=0.980). Multivariate regression analysis with adjustment for potential confounders showed a median of distolic BP (P=0.024, OR: 0.977, 95% CI: 0.957 to 0.997) as a predictor of good functional outcome after MT, and a median of maximal SBP (P=0.038; OR: 0.990, 95% CI: 0.981 to 0.999) in the patients with achieved recanalization. Conclusion Lowering of BP within the first 24 hours after MT may have a positive impact on clinical outcome in treated patients. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
17598478
Volume :
11
Issue :
8
Database :
Complementary Index
Journal :
Journal of NeuroInterventional Surgery
Publication Type :
Academic Journal
Accession number :
137650629
Full Text :
https://doi.org/10.1136/neurintsurg-2018-014548