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Single Mean Arterial Blood Pressure Drops During Stroke Thrombectomy Under General Anaesthesia Are Associated With Poor Outcome

By Currents Editor posted 22 days ago

  

Journal of Neurology (01/18/20)  doi: 10.1007/s00415-020-09701-x
Fandler-Höfler, Simon; Heschl, Stefan; Argüelles-Delgado, Placido; et al.


Declines in mean arterial pressure (MAP) below 60 mmHg during general anesthesia (GA) for stroke patients undergoing mechanical thrombectomy (MT) are independently associated with worse functional outcome three months after the stroke, according to new research. The retrospective cohort study, conducted at a single center in Austria, involved adults who had received MT because of anterior circulation large vessel occlusion stroke between January 2011 and June 2016. In all, 115 patients who had continuous invasive periinterventional blood pressure monitoring were included. Clinical and radiological data for all patients at the facility were prospectively gathered as part of a continuing cohort study, while periinterventional monitoring data were obtained from electronic anesthesia records. Univariable and multivariable regression were used to evaluate the effects of different blood pressure values on outcome, which was measured with modified Rankin Scale scores at three months post-stroke. The data show that 51.3% of the patients had a favorable functional outcome at three months, and 12.2% had died. Patients with poor outcomes tended to be older, have more severe stroke syndromes based on the National Institutes of Health Stroke Severity Scale, and were more likely to have hypertension and diabetes. Outcome was not affected by periinterventional systolic, diastolic, and MAP values averaged across MT. But single blood pressure drops, particularly a MAP lower than 60 mmHg, were associated with poor outcome.

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