Association of Hypotension During Thrombectomy and Outcomes Differs With the Posterior Communicating Artery Patency
| Autor: | Benjamin Maïer, Erwan Robichon, Romain Bourcier, Cyril Dargazanli, Julien Labreuche, Laurie-Anne Thion, Morgan Leguen, Romuald Riem, Jean-Philippe Desilles, Grégoire Boulouis, François Delvoye, Solène Hebert, Hocine Redjem, Stanislas Smajda, Simon Escalard, Raphaël Blanc, Michel Piotin, Bertrand Lapergue, Mikael Mazighi, Robert Fahed, Malek Ben Maacha, Georges Rodesch, Arturo Consoli, Aguzhan Coskun, Federico Di Maria, Frédéric Bourdain, Jean-Pierre Decroix, Adrien Wang, Maya Tchikviladze, Serge Evrard, Delphine Lopez, Francis Turjman, Benjamin Gory, Paul-Emile Labeyrie, Roberto Riva, Charbel Mounayer, Suzanna Saleme, Vincent Costalat, Alain Bonafé, Omer Eker, Grégory Gascou, Cyril Darganzali, Serge Bracard, Romain Tonnelet, Anne Laure Derelle, René Anxionnat, Hubert Desal, Benjamin Daumas Duport, Jérome Berge, Xavier Barreau, Gauthier Margnat, Lynda Djemmane, Alain Duhamel |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Hemodynamics Blood Pressure Endovascular therapy 030218 nuclear medicine & medical imaging Brain Ischemia 03 medical and health sciences 0302 clinical medicine Internal medicine medicine.artery medicine Humans Posterior communicating artery Acute ischemic stroke Ischemic Stroke Thrombectomy Advanced and Specialized Nursing business.industry Endovascular Procedures Stroke Blood pressure Treatment Outcome Ischemic stroke Cardiology Neurology (clinical) Hypotension Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery |
| Zdroj: | Stroke. 52(9) |
| ISSN: | 1524-4628 |
| Popis: | Background and Purpose: Hypotension during endovascular therapy for acute ischemic stroke is associated with worse functional outcomes (FO). Given its important role in intracranial hemodynamics, we investigated whether hypotension during endovascular therapy had the same effect on FO according to the posterior communicating artery (PComA) patency. Methods: We performed a post hoc analysis of the ASTER trial (Contact Aspiration Versus Stent Retriever for Successful Revascularization). Patients were included if they had middle cerebral artery occlusions. Primary outcome was favorable FO, defined by a modified Rankin Scale scores between 0 and 2 at 3 months. Results: One hundred forty-eight patients with middle cerebral artery occlusion were included. In patients with no PComA, an increase in minimum mean arterial pressure was positively associated with favorable FO (odds ratio per 10 mm Hg increase, 1.59 [95%CI, 1.11–2.25]; P =0.010), whereas no association was found in patients with a PComA (odds ratio, 0.77 [95% CI, 0.54–1.08]; P =0.12). Patients with no PComA and longer cumulative time with mean arterial pressure P =0.010) and 0.74 (95% CI, 0.60–0.91; P =0.003), but not in patients with a PComA. Conclusions: Hypotension during endovascular therapy for middle cerebral artery occlusion is consistently associated with worse FO in patients with no PComA but not in those with a PComA. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02523261. |
| Databáze: | OpenAIRE |
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