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Tytuł:
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Admission Blood Pressure and Outcome of Endovascular Therapy: Secondary Analysis of ASTER Trial.
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Autorzy:
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Anadani M; Department of Neurology, Washington University School of Medicine, St Louis, MO, United States. Electronic address: .
Lapergue B; Department of Stroke Center, Foch Hospital, Suresnes, France. Electronic address: .
Blanc R; Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France. Electronic address: .
Kyheng M; Department of Biostatistics, University Lille, CHU Lille, EA 2694-Santé Publique: Epidémiologie et Qualité des Soins, France. Electronic address: .
Labreuche J; Department of Biostatistics, University Lille, CHU Lille, EA 2694-Santé Publique: Epidémiologie et Qualité des Soins, France. Electronic address: .
Machaa MB; Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France. Electronic address: .
Duhamel A; Department of Biostatistics, University Lille, CHU Lille, EA 2694-Santé Publique: Epidémiologie et Qualité des Soins, France. Electronic address: .
Marnat G; Department of Neuroradiology, University Hospital of Bordeaux, France. Electronic address: .
Saleme S; Department of Interventional Neuroradiology, University Hospital of Limoges, France. Electronic address: .
Costalat V; Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier, France. Electronic address: .
Bracard S; Department of Diagnostic and Therapeutic Neuroradiology, University Hospital of Nancy, Université de Lorraine, INSERM U1254, Nancy, France. Electronic address: .
Anxionnat R; Department of Diagnostic and Therapeutic Neuroradiology, University Hospital of Nancy, Université de Lorraine, INSERM U1254, Nancy, France. Electronic address: .
Spiotta AM; Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, United States. Electronic address: .
DeHavenon A; Department of Neurology, Utah University, Salt lake, UT, United States. Electronic address: .
Richard S; Department of Neurology, Stroke Unit, University Hospital of Nancy, Université de Lorraine, INSERM U1116, Nancy, France. Electronic address: .
Desal H; Department of Neuroradiology, Guillaume et René Laennec University Hospital, Nantes, France. Electronic address: .
Mazighi M; Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France. Electronic address: .
Consoli A; Department of Neuroradiology, Foch Hospital, Suresnes, France. Electronic address: .
Piotin M; Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France. Electronic address: .
Gory B; Department of Diagnostic and Therapeutic Neuroradiology, University Hospital of Nancy, Université de Lorraine, INSERM U1254, Nancy, France. Electronic address: .
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Źródło:
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Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2020 Dec; Vol. 29 (12), pp. 105347. Date of Electronic Publication: 2020 Oct 03.
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Typ publikacji:
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Journal Article; Multicenter Study; Randomized Controlled Trial
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Język:
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English
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Imprint Name(s):
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Publication: Philadelphia, PA : Saunders
Original Publication: New York, NY : Demos Publications, [1991-
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MeSH Terms:
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Blood Pressure*
Endovascular Procedures*/adverse effects
Patient Admission*
Thrombectomy*/adverse effects
Brain Ischemia/*therapy
Hypertension/*physiopathology
Stroke/*therapy
Aged ; Aged, 80 and over ; Brain Ischemia/complications ; Brain Ischemia/diagnosis ; Brain Ischemia/physiopathology ; Cerebral Hemorrhage/etiology ; Female ; Humans ; Hypertension/complications ; Hypertension/diagnosis ; Male ; Middle Aged ; Recovery of Function ; Risk Factors ; Stroke/complications ; Stroke/diagnosis ; Stroke/physiopathology ; Time Factors ; Treatment Outcome
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Contributed Indexing:
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Keywords: Blood pressure; Cerebral hemorrhage; Stroke; Thrombectomy
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Entry Date(s):
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Date Created: 20201005 Date Completed: 20201208 Latest Revision: 20201214
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Update Code:
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20240105
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DOI:
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10.1016/j.jstrokecerebrovasdis.2020.105347
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PMID:
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33017755
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Background: Elevated blood pressure (BP) is common among patients presenting with acute ischemic stroke due to large vessel occlusions. The literature is inconsistent regarding the association between admission BP and outcome of mechanical thrombectomy (MT). Moreover, it is unclear whether the first line thrombectomy strategy (stent retriever [SR] versus contact aspiration [CA]) modifies the relationship between BP and outcome.
Methods: This is a post hoc analysis of the ASTER (Contact Aspiration Versus Stent Retriever for Successful Revascularization) randomized trial. BP was measured prior to randomization in all included patients. Co-primary outcomes included 90-day functional independence (modified Rankin Scale [mRS] 0-2) and successful revascularization (modified Treatment in Cerebral Ischemia [mTICI] 2b-3). Secondary outcomes included symptomatic intracerebral hemorrhage (sICH) and parenchymal hemorrhage (PH) within 24 hours.
Results: A total of 381 patients were included in the present study. Mean (SD) systolic BP (SBP) and diastolic BP (DBP) were 148 (26) mm Hg and 81 (16) mm Hg, respectively. There was no association between SBP or DBP and successful revascularization or 90-day functional independence. Similarly, there was no association between admission SBP or DBP with sICH or PH. Subgroup analysis based on the first-line thrombectomy strategy revealed similar results with no heterogeneity across groups.
Conclusion: Admission BP was not associated with functional, angiographic or safety outcomes. Results were similar in both CA and CA groups.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
