MedStar Authors catalog › Details for: Blood pressure levels post mechanical thrombectomy and outcomes in non-recanalized large vessel occlusion patients.
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Blood pressure levels post mechanical thrombectomy and outcomes in non-recanalized large vessel occlusion patients.

by Chang, Jason J.
Citation: Journal of Neurointerventional Surgery. 10(10):925-931, 2018 Oct..Journal: Journal of neurointerventional surgery.Published: 2018ISSN: 1759-8478.Full author list: Goyal N; Tsivgoulis G; Pandhi A; Dillard K; Alsbrook D; Chang JJ; Krishnaiah B; Nickele C; Hoit D; Alsherbini K; Alexandrov AV; Arthur AS; Elijovich L.UI/PMID: 29326379.Subject(s): Adult | Aged | *Blood Pressure/ph [Physiology] | *Cerebrovascular Disorders/di [Diagnosis] | Cerebrovascular Disorders/pp [Physiopathology] | Cerebrovascular Disorders/su [Surgery] | Cohort Studies | Female | Humans | *Hypertension/di [Diagnosis] | Hypertension/et [Etiology] | Hypertension/pp [Physiopathology] | Male | Middle Aged | Prospective Studies | Retrospective Studies | Thrombectomy/ae [Adverse Effects] | *Thrombectomy/td [Trends] | Treatment OutcomeInstitution(s): MedStar Washington Hospital CenterDepartment(s): Critical CareActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1136/neurintsurg-2017-013581 (Click here) Abbreviated citation: J Neurointerv Surg. 10(10):925-931, 2018 Oct.Local Holdings: Available online through MWHC library: 2009 - present.Abstract: OBJECTIVE: Permissive hypertension may benefit patients with non-recanalized large vessel occlusion (nrLVO) post mechanical thrombectomy (MT) by maintaining brain perfusion. Data evaluating the impact of post-MT blood pressure (BP) levels on outcomes in nrLVO patients are scarce. We investigated the association of the post-MT BP course with safety and efficacy outcomes in nrLVO.Abstract: METHODS: Hourly systolic BP (SBP) and diastolic BP (DBP) values were prospectively recorded for 24hours following MT in consecutive nrLVO patients. Maximum, minimum, and mean BP levels were documented. Three-month functional independence (FI) was defined as modified Rankin Scale (mRS) scores of 0-2.Abstract: RESULTS: A total of 88 nrLVO patients were evaluated post MT. Patients with FI had lower maximum SBP (160+/-19mmHg vs 179+/-23mmHg; P=0.001) and higher minimum SBP levels (119+/-12mmHg vs 108+/-25mmHg; P=0.008). Maximum SBP (183+/-20mmHg vs 169+/-23mmHg; P=0.008) and DBP levels (105+/-20mmHg vs 89+/-18mmHg; P=0.001) were higher in patients who died at 3 months while minimum SBP values were lower (102+/-28mmHg vs 115+/-16mmHg; P=0.007). On multivariable analyses, both maximum SBP (OR per 10mmHg increase: 0.55, 95%CI 0.39 to 0.79; P=0.001) and minimum SBP (OR per 10mmHg increase: 1.64, 95%CI 1.04 to 2.60; P=0.033) levels were independently associated with the odds of FI. Maximum DBP (OR per 10mmHg increase: 1.61; 95%CI 1.10 to 2.36; P=0.014) and minimum SBP (OR per 10mmHg increase: 0.65, 95%CI 0.47 to 0.90; P=0.009) values were independent predictors of 3-month mortality.Abstract: CONCLUSIONS: Our study demonstrates that wide BP excursions from the mean during the first 24hours post MT are associated with worse outcomes in patients with nrLVO.Abstract: Copyright (c) Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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