Blood pressure reduction and outcome after endovascular therapy with successful reperfusion: a multicenter study

Autor: Jan Liman, Ali Alawieh, Ovais Inamullah, Yser Orabi, Shareena Rahman, Fábio A. Nascimento, Adam S Arthur, Peter Kan, Christa B. Swisher, Andrei V. Alexandrov, Marios-Nikos Psychogios, Mohammad Anadani, Alejandro M Spiotta, Sébastien Richard, Joon-Tae Kim, Pierre De Marini, James A Giles, Stacey Q Wolfe, Chesney S Oravec, Ilko Maier, Saleh G. Keyrouz, Georgios Tsivgoulis, Michelle Allen, Nitin Goyal, Abhi Pandhi, Adam de Havenon, Sreeja Kodali, Nils H Petersen, Benjamin Gory, Bradley A. Cagle
Přispěvatelé: Medical University of South Carolina [Charleston] (MUSC), The University of Tennessee Health Science Center [Memphis] (UTHSC), University Medical Center Göttingen (UMG), Chonnam National University [Gwangju], Washington University School of Medecine [Saint Louis, MO], University of Utah, Yale University [New Haven], Duke University Medical Center, Wake Forest School of Medicine [Winston-Salem], Wake Forest Baptist Medical Center, University of Athens Medical School [Athens], Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Baylor College of Medicine (BCM), Baylor University, Service de neurologie [CHRU Nancy]
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Blood Pressure
[SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine
030204 cardiovascular system & hematology
Endovascular therapy
Article
Brain Ischemia
03 medical and health sciences
0302 clinical medicine
Modified Rankin Scale
Internal medicine
Mixed linear model
medicine
[INFO.INFO-IM]Computer Science [cs]/Medical Imaging
Humans
Stroke
Aged
Retrospective Studies
Thrombectomy
Intracerebral hemorrhage
Aged
80 and over
business.industry
Endovascular Procedures
Retrospective cohort study
Blood Pressure Determination
General Medicine
Middle Aged
medicine.disease
3. Good health
Blood pressure
Treatment Outcome
Multicenter study
Hypertension
Reperfusion
Cardiology
Surgery
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Zdroj: Journal of Neurointerventional Surgery
Journal of Neurointerventional Surgery, BMJ Journals, 2020, 12 (10), pp.932-936. ⟨10.1136/neurintsurg-2019-015561⟩
J Neurointerv Surg
ISSN: 1759-8478
1759-8486
Popis: BackgroundElevated systolic blood pressure (SBP) after mechanical thrombectomy (MT) correlates with worse outcome. However, the association between SBP reduction (SBPr) and outcome after successful reperfusion with MT is not well established.ObjectiveTo investigate the association between SBPr in the first 24 hours after successful reperfusion and the functional and safety outcomes of MT.MethodsA multicenter retrospective study, which included 10 comprehensive stroke centers, was carried out. Patients with acute ischemic stroke and anterior circulation large vessel occlusions who achieved successful reperfusion via MT were included. SBPr was calculated using the formula 100×([admission SBP−mean SBP]/admission SBP). Poor outcome was defined as a modified Rankin Scale (mRS) score of 3–6 at 90 days. Safety endpoints included symptomatic intracerebral hemorrhage, mortality, and requirement for hemicraniectomy during admission. A generalized mixed linear model was used to study the association between SBPr and outcomes.ResultsA total of 1361 patients were included in the final analysis. SBPr as a continuous variable was inversely associated with poor outcome (OR=0.97; 95% CI 0.95 to 0.98; p20%), the rate of poor outcome was highest in the first group.ConclusionSBPr in the first 24 hours after successful reperfusion was inversely associated with poor outcome. No association between SBPr and safety outcome was found.
Databáze: OpenAIRE
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