Association of blood pressure and outcomes differs upon cerebral perfusion post-thrombectomy in patients with acute ischemic stroke

So we still have NO stroke medical 'professional' that looks at this problem on blood pressure management post stroke and says: 'We need to solve this immediately'. Which is why we need survivors in charge instead of the fucking failures currently there!

Send me hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and my response in my blog. Or are you afraid to engage with my stroke-addled mind?  Survivors would like to know why you are being so fucking incompetent!

 Association of blood pressure and outcomes differs upon cerebral perfusion post-thrombectomy in patients with acute ischemic stroke

1. http://orcid.org/0000-0002-5922-8216Jinjie Liu1,
2. Ximing Nie1,2,
3. Zhe Zhang1,2,
4. Wanying Duan1,2,
5. Xin Liu1,2,
6. Hongyi Yan1,2,
7. http://orcid.org/0000-0003-1501-0351Lina Zheng1,2,
8. Changgeng Fang1,2,
9. Jiaping Chen1,2,
10. Yuyi Wang1,2,
11. Zhixuan Wen1,2,
12. Shuning Cai1,2,
13. Miao Wen1,2,
14. Zhonghua Yang1,2,
15. http://orcid.org/0000-0003-3082-6789Yuesong Pan1,2,
16. Sibo Liu3,
17. Liping Liu1,2

1. Correspondence to Liping Liu, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China, No.119, South 4th Ring West Road, Fengtai District; lipingsister@gmail.com

Abstract

Background The relationship between post-endovascular thrombectomy (EVT) blood pressure (BP) and outcomes in patients with acute ischemic stroke (AIS) remains contentious. We aimed to explore whether this association differs with different cerebral perfusion statuses post-EVT.

Methods In a multicenter observational study of patients with AIS with large vessel occlusion who underwent EVT, we enrolled those who accepted CT perfusion (CTP) imaging within 24 hours post-EVT. We recorded post-EVT systolic (SBP) and diastolic BP. Patients were stratified into favorable perfusion and unfavorable perfusion groups based on the hypoperfusion intensity ratio (HIR) on CTP. The primary outcome was good functional outcome (90-day modified Rankin Scale score of ≤3). Secondary outcomes included early neurological deterioration, infarct size growth, and symptomatic intracranial hemorrhage.

Results Of the 415 patients studied (mean age 62 years, 75% male), 233 (56%) achieved good functional outcomes. Logistic regression showed that post-EVT HIR and 24-hour mean SBP were significantly associated with functional outcomes. Among the 326 (79%) patients with favorable perfusion, SBP <140 mmHg was associated with a higher percentage of good functional outcomes compared with SBP ≥140 mmHg (68% vs 52%; aOR 1.70 (95% CI 1.00 to 2.89), P=0.04). However, no significant difference was observed between SBP and functional outcomes in the unfavorable perfusion group. There was also no discernible difference between SBP and secondary outcomes across the different perfusion groups.

Conclusions In patients with favorable perfusion post-EVT, SBP <140 mmHg was associated with good functional outcomes, which underscores the need for further investigations(With NO stroke leadership; NOTHING WILL OCCUR!) with larger sample sizes or a more individualized BP management strategy.

Clinical trial registration ChiCTR1900022154.

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable.

https://doi.org/10.1136/jnis-2024-021487