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The decrease in blood pressure (BP) during endovascular therapy (EVT) is associated with infarct progression and poor prognosis after large vessel occlusive (LVO) stroke.
However, the BP trajectory in the hyperacute phase of EVT has not been well described.
In order to evaluate the relationship between LVO hyperacute BP reduction and infarct progression and functional outcome.
The results of a recent study further proved that lower blood pressure before reperfusion may accelerate the risk of infarction progression and poor functional prognosis.
The results were announced at the 2021 American Academy of Neurology (AAN) annual meeting.
Author of this article: Yimaitong AAN report group Yimaitong compiled and compiled, please do not reprint without authorization.
Research Introduction Dr.
Krithika's team conducted a prospective study, including patients with LVO who received EVT, using noninvasive finger stroke hemoplethysmography to record high-frequency BP, and using high-frequency BP and hemodynamic monitoring to study stroke ultrasonography.
The timing of BP reduction in the acute phase.
At the same time, the patient received the initial CT and MRI examination within 24 hours to calculate the incidence of infarction.
Exposure variables were defined as: the difference between the mean arterial pressure (MAP) at admission and the lowest MAP (ΔMAP), MAP decreased> 20%, and the MAP functional outcome was assessed using the modified Rankin Scale (mRS) at 90 days.
Researchers used linear regression and logistic regression to study the relationship between BP decline and prognosis.
Main findings: ➤45 patients (age: 72±17; female: 58%; NIHSS: 13±6) received continuous BP monitoring.
The aggregated time series data showed that the patient's blood pressure decreased significantly before and after the imaging time, and the patient recovered thereafter.
After the inguinal puncture, the patient's blood pressure continued to drop and did not return to the baseline level.➤The linear regression results show that for every 10mmHg decrease in ΔMAP, the infarct area increases by 13ml (p=0.
054).
Patients were divided into two groups according to the median ΔMAP of 29.
Patients with ΔMAP≤29 had a better functional prognosis at 90 days (34.
78% vs.
9.
09%, p=0.
038).
The conclusion of the study is that the iatrogenic blood pressure is significantly reduced during the initial imaging, which may be a potential target for therapeutic intervention.
Lower blood pressure before reperfusion may accelerate the infarct progression and the risk of poor functional prognosis.
Throughout the acute stroke, changes in cardiac hemodynamics suggest the potential effect of fluid resuscitation on hemodynamic optimization.
Yimaitong compiled from: Blood PressureReductions in the Hyperacute Phase of Large Vessel Occlusion Ischemic StrokeAre Associated with Infarct Progression and Poor Functional Outcome.
AAN 2021.
Locked on the medlive-neurology channel for the latest information of AAN 2021.
! Yimaitong AAN 2021 special report Long press the QR code to follow ☟☟☟ or click "Read the original text" to see more AAN 2021 special related content!
However, the BP trajectory in the hyperacute phase of EVT has not been well described.
In order to evaluate the relationship between LVO hyperacute BP reduction and infarct progression and functional outcome.
The results of a recent study further proved that lower blood pressure before reperfusion may accelerate the risk of infarction progression and poor functional prognosis.
The results were announced at the 2021 American Academy of Neurology (AAN) annual meeting.
Author of this article: Yimaitong AAN report group Yimaitong compiled and compiled, please do not reprint without authorization.
Research Introduction Dr.
Krithika's team conducted a prospective study, including patients with LVO who received EVT, using noninvasive finger stroke hemoplethysmography to record high-frequency BP, and using high-frequency BP and hemodynamic monitoring to study stroke ultrasonography.
The timing of BP reduction in the acute phase.
At the same time, the patient received the initial CT and MRI examination within 24 hours to calculate the incidence of infarction.
Exposure variables were defined as: the difference between the mean arterial pressure (MAP) at admission and the lowest MAP (ΔMAP), MAP decreased> 20%, and the MAP functional outcome was assessed using the modified Rankin Scale (mRS) at 90 days.
Researchers used linear regression and logistic regression to study the relationship between BP decline and prognosis.
Main findings: ➤45 patients (age: 72±17; female: 58%; NIHSS: 13±6) received continuous BP monitoring.
The aggregated time series data showed that the patient's blood pressure decreased significantly before and after the imaging time, and the patient recovered thereafter.
After the inguinal puncture, the patient's blood pressure continued to drop and did not return to the baseline level.➤The linear regression results show that for every 10mmHg decrease in ΔMAP, the infarct area increases by 13ml (p=0.
054).
Patients were divided into two groups according to the median ΔMAP of 29.
Patients with ΔMAP≤29 had a better functional prognosis at 90 days (34.
78% vs.
9.
09%, p=0.
038).
The conclusion of the study is that the iatrogenic blood pressure is significantly reduced during the initial imaging, which may be a potential target for therapeutic intervention.
Lower blood pressure before reperfusion may accelerate the infarct progression and the risk of poor functional prognosis.
Throughout the acute stroke, changes in cardiac hemodynamics suggest the potential effect of fluid resuscitation on hemodynamic optimization.
Yimaitong compiled from: Blood PressureReductions in the Hyperacute Phase of Large Vessel Occlusion Ischemic StrokeAre Associated with Infarct Progression and Poor Functional Outcome.
AAN 2021.
Locked on the medlive-neurology channel for the latest information of AAN 2021.
! Yimaitong AAN 2021 special report Long press the QR code to follow ☟☟☟ or click "Read the original text" to see more AAN 2021 special related content!
