Prognostic Significance of Blood Pressure Parameters After Mechanical Thrombectomy According to Collateral Status

Overview

Journal BMC Neurol

Publisher Biomed Central

Specialty Neurology

Date 2023 Mar 28

PMID 36978000

Authors

Huaishun Wang

Huihui Liu

Qianmei Jiang

Shoujiang You

Zhiliang Guo

Jie Hou

Guodong Xiao

Affiliations

Soon will be listed here.

Abstract

Background: Mechanical thrombectomy (MT) has been proven as an effective and safe therapy for patients with acute ischemic stroke from large vessel occlusion. However, there is still a controversial topic about post-procedural management including blood pressure (BP).

Methods: A total of 294 patients who received MT in Second Affiliated Hospital of Soochow University from April 2017 to September 2021 were included consecutively. The association of blood pressure parameters (BPV and hypotension time) with poor functional outcome was evaluated using logistic regression models. Meanwhile, the effects of BP parameters on mortality was analyzed using cox proportional hazards regression models. Furthermore, the corresponding multiplicative term was added to the above models to study the interaction between BP parameters and CS.

Results: Two hundred ninety four patients were included finally. The mean age was 65.5 years. At the 3-month follow-up, 187(61.5%) had poor functional outcome and 70(23.0%) died. Regardless of the CS, BP CV is positively associated with poor outcome. Hypotension time was negatively associated with poor outcome. We conducted a subgroup analysis according to CS. BPV was significantly associated with mortality at 3-month and displayed a trend toward poor outcome for patients with poor CS only. The interaction between SBP CV and CS with respect to mortality after adjusting for confounding factors was statistically significant (P for interaction = 0.025) and the interaction between MAP CV and CS with respect to mortality after multivariate adjustment was also statistically significant (P for interaction = 0.005).

Conclusion: In MT-treated stroke patients, higher BPV in the first 72 h is significantly associated with poor functional outcome and mortality at 3-month regardless of CS. This association was also found for hypotension time. Further analysis showed CS modified the association between BPV and clinical prognosis. BPV displayed a trend toward poor outcome for patients with poor CS.

Citing Articles

The Presence of Communicating Arteries in the Circle of Willis Is Associated with Higher Rate of Functional Recovery after Anterior Circulation Ischemic Stroke.

Sablic S, Dolic K, Kraljevic I, Budimir Mrsic D, cicmir-Vestic M, Benzon B Biomedicines. 2023; 11(11).

PMID: 38002008 PMC: 10669712. DOI: 10.3390/biomedicines11113008.

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