Highlights
- •Average systolic blood pressure (SBP) post mechanical thrombectomy (MT) was associated with the functional outcome.
- •We did not find an association between blood pressure and hemorrhagic transformation.
- •Patients with average SBP less than 120 mm Hg had a higher rate of good functional outcome and a lower mortality rate.
- •Prospective studies are needed to determine the optimal blood pressure target post MT.
Abstract
Data on the blood pressure (BP) following mechanical thrombectomy (MT) is limited.
In this study, we aimed to evaluate the correlation between BP and functional outcome
following MT. We included patients who received MT between 6/12014 and 2/2017 at our
institution. BP data included systolic, diastolic, and mean arterial BP readings recorded
on an hourly interval for 24 h post-procedure. Functional outcome was assessed using
90-day modified Rankin Scale (mRS). Good outcome was defined as mRS ≤ 2, and poor
outcome as mRS 3–6.
A total of 298 patients were included. Mean age was 66.8 ± 15.2 years; 51% of patients
were female, and mean NIHSS was 15.4 ± 7.7. Average systolic blood pressure (SBP)
was 121 ± 11.5 mm Hg in the good outcome group and 125 ± 12.5 mm Hg in the poor outcome;
P < 0.001. Maximum SBP was 147.9 ± 20.5 mm Hg and 152.5 ± 18.3 mm Hg in the good and
poor outcome group respectively, P < 0.05. On multivariate analysis, higher average
SBP was associated with a lower chance of good outcome (Odds ratio 0.97; 95% Confidence
interval 0.94–0.998; P 0.026). Patients with average SBP of <120 mm Hg in 24-hour
post MT had a better 90-day outcome and a lower mortality rate when compared to patients
with ≥120 mm Hg (median mRS; 2 (IQR 3) vs 3 (IQR4); P < 0.001, mortality (12.1% vs
25.9%; P < 0.01)). In conclusion, higher SBP in the acute phase post-MT was associated
with a worse functional outcome. Prospective studies are urgently needed to determine
the optimal BP goal post MT.
Keywords
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Article info
Publication history
Published online: December 26, 2018
Accepted:
December 11,
2018
Received:
August 30,
2018
Identification
Copyright
© 2018 Elsevier Ltd. All rights reserved.
