Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2020 Jun;87(6):830-839.
doi: 10.1002/ana.25716. Epub 2020 Apr 3.

Blood Pressure Goals and Clinical Outcomes after Successful Endovascular Therapy: A Multicenter Study

Mohammad Anadani  1   2 , Adam S Arthur  2 , Georgios Tsivgoulis  3 , Kit N Simpson  4 , Ali Alawieh  1 , Yser Orabi  2 , Nitin Goyal  5 , Andrei V Alexandrov  6 , Ilko L Maier  5 , Marios-Nikos Psychogios  5 , Jan Liman  5 , Daniel Brinton  7 , Christa B Swisher  8 , Shreyash Shah  8 , Ovais Inamullah  8 , Salah Keyrouz  9 , Akash P Kansagra  9 , Michelle Allen  9 , James A Giles  9 , Stacey Q Wolfe  10 , Kyle M Fargen  10 , Benjamin Gory  11 , Pierre De Marini  11 , Peter Kan  12 , Fábio A Nascimento  13 , Eyad Almallouhi  2 , Nils Petersen  14 , Sreeja Kodali  14 , Shareena Rahman  8 , Sébastien Richard  15 , Alejandro M Spiotta  1
Affiliations
Multicenter Study

Blood Pressure Goals and Clinical Outcomes after Successful Endovascular Therapy: A Multicenter Study

Mohammad Anadani et al. Ann Neurol. 2020 Jun.

Abstract

Objective: Elevated systolic blood pressure (SBP) after successful revascularization (SR) via endovascular therapy (EVT) is a known predictor of poor outcome. However, the optimal SBP goal following EVT is still unknown. Our objective was to compare functional and safety outcomes between different SBP goals after EVT with SR.

Methods: This international multicenter study included 8 comprehensive stroke centers and patients with anterior circulation large vessel occlusion who were treated with EVT and achieved SR. SR was defined as modified thrombolysis in cerebral ischemia 2b to 3. Patients were divided into 3 groups based on SBP goal in the first 24 hours after EVT. Inverse probability of treatment weighting (IPTW) propensity analysis was used to assess the effect of different SBP goals on clinical outcomes.

Results: A total of 1,019 patients were included. On IPTW analysis, the SBP goal of <140mmHg was associated with a higher likelihood of good functional outcome and lower odds of hemicraniectomy compared to SBP goal of <180mmHg. Similarly, SBP goal of <160mmHg was associated with lower odds of mortality compared to SBP goal of <180mmHg. In subgroup analysis including only patients with pre-EVT SBP of ≥140mmHg, an SBP of <140mmHg was associated with a higher likelihood of good functional outcome, lower odds of symptomatic intracranial hemorrhage, and lower odds of requirement for hemicraniectomy compared to SBP goal of <180mmHg.

Interpretation: SBP goals of <140 and < 160mmHg following SR with EVT appear to be associated with better clinical outcomes than SBP of <180mmHg. ANN NEUROL 2020;87:830-839.

PubMed Disclaimer

References

    1. McManus M, Liebeskind DS. Blood pressure in acute ischemic stroke. J Clin Neurol 2016;12:137-146.
    1. Malhotra K, Goyal N, Katsanos AH, Filippatou A, Mistry EA, Khatri P, Anadani M, Spiotta AM, Sandset EC, Sarraj A, Magoufis G. Association of blood pressure with outcomes in acute stroke thrombectomy. Hypertension 2020;75:730-739.
    1. Goyal N, Tsivgoulis G, Pandhi A, et al. Blood pressure levels post mechanical thrombectomy and outcomes in non-recanalized large vessel occlusion patients. J Neurointerv Surg 2018;10:925-931.
    1. Mistry EA, Mayer SA, Khatri P. Blood pressure management after mechanical thrombectomy for acute ischemic stroke: a survey of the strokenet sites. J Stroke Cerebrovasc Dis 2018;27:2474-2478.
    1. Anadani M, Orabi Y, Alawieh A, et al. Blood pressure and outcome post mechanical thrombectomy. J Clin Neurosci 2018;62:94-99.

Publication types

LinkOut - more resources