Effect of Steady and Dynamic Blood Pressure Parameters During Thrombectomy According to the Collateral Status

Stroke; a Journal of Cerebral Circulation
Benjamin MaïerASTER Trial

Abstract

Background and Purpose- Guidelines regarding blood pressure (BP) management during endovascular therapy (EVT) for anterior circulation strokes are questionable since the optimal BP target is a matter of debate. To evaluate the importance of hemodynamic control during EVT, we investigated the impact of dynamic and steady BP parameters during EVT on functional outcome (part 1) and according to the collateral status (CS; part 2). Methods- We performed a post hoc analysis of the ASTER trial (Contact Aspiration Versus Stent Retriever for Successful Recanalization). BP was measured noninvasively during EVT and CS assessed on the angiographic run before EVT. We studied dynamic BP parameter using BP variability (coefficient of variation) and steady BP parameter (hypotension time defined as systolic BP <140 mm Hg and mean arterial pressure <90 mm Hg). The primary outcome was favorable outcome defined as a 3-month modified Rankin Scale score between 0 and 2. Results- Among the 381 patients of the ASTER study, 172 patients were included in part 1 and 159 in part 2. Systolic BP, diastolic BP, and mean arterial pressure variability were negatively associated with favorable outcome regardless of CS: per 10-unit increase, adjusted odds ratios...Continue Reading

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Aug 30, 2019·Stroke; a Journal of Cerebral Circulation·Benjamin MaïerMikael Mazighi

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Citations

Feb 12, 2021·Risk Management and Healthcare Policy·Kexin WuYasuo Ding
Dec 29, 2020·Frontiers in Neurology·Benjamin MaïerMikael Mazighi
Mar 23, 2021·Therapeutic Advances in Neurological Disorders·Xianjun HuangXinfeng Liu
Jun 18, 2021·Stroke; a Journal of Cerebral Circulation·Benjamin MaïerUNKNOWN ASTER Trial†

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