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Spontaneous systolic blood pressure drop early after mechanical thrombectomy predicts dramatic neurological recovery in ischaemic stroke patients

2020Journal article Open access
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dc.contributor.authorCarvalho Dias, Mariana
dc.contributor.authorGabriel, Denis
dc.contributor.authorSaraiva, Marlene
dc.contributor.authorCampos, Daniel
dc.contributor.authorRequena, Manuel
dc.contributor.authorGarcía-Tornel, Álvaro
dc.contributor.authorMuchada, Marian
dc.contributor.authorBoned, Sandra
dc.contributor.authorRodriguez-Luna, David
dc.contributor.authorRodriguez-Villatoro, Noelia
dc.contributor.authorPagola, Jorge
dc.contributor.authorJuega, Jesus
dc.contributor.authorDeck, Matías
dc.contributor.authorRibo, Marc
dc.contributor.authorTomasello, Alejandro
dc.contributor.authorMolina, Carlos A
dc.contributor.authorRubiera, Marta
dc.date.accessioned2021-11-23T14:15:04Z
dc.date.available2021-11-23T14:15:04Z
dc.date.issued2020
dc.description.abstractIntroduction: Spontaneous blood pressure drop within the first 24 h has been reported following arterial recanalisation in ischaemic stroke patients. We aimed to assess if spontaneous blood pressure drop within the first hour after mechanical thrombectomy is a marker of early neurological recovery. Patients and methods: Retrospective observational single-centre study including ischaemic stroke patients treated with mechanical thrombectomy. Blood pressure parameters from admission, mechanical thrombectomy start, mechanical thrombectomy end and hourly within 24 h after mechanical thrombectomy were reviewed. Primary outcome was early dramatic neurological recovery (8-point-reduction in NIHSS or NIHSS ≤ 2 at 24 h). Secondary outcome was functional independence at 90 days (mRankin 0-2). Results: We included 458 patients in our analysis. Two-hundred (43.7%) patients achieved dramatic neurological recovery following mechanical thrombectomy. One hour after mechanical thrombectomy end, median systolic blood pressure was significantly different between outcome groups (129 vs. 138 mmHg, p = 0.005) and a higher drop in median systolic blood pressure was seen in the dramatic neurological recovery group (15 vs. 9 mmHg). Optimal cut-off for predicting dramatic neurological recovery was a systolic blood pressure drop of 10.5 mmHg (sensitivity 0.54, specificity 0.55, AUC 0.55). On multivariate analysis, spontaneous systolic blood pressure drop was associated with higher odds of achieving dramatic neurological recovery (OR for 10 mmHg blood pressure drop 1.14, 95% CI 1.01-1.29, p = 0.04). No significative association between any blood pressure parameter drop and functional independence at 90 days was found. Discussion: We hypothesised that spontaneous systolic blood pressure drop is a marker of successful reperfusion and, therefore, a marker of improvement of cerebral autoregulation due to the reduced final ischaemic core. Conclusion: Spontaneous systolic blood pressure drop after mechanical thrombectomy is an early predictor of dramatic neurological recovery.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationCarvalho Dias M, Gabriel D, Saraiva M, et al. Spontaneous systolic blood pressure drop early after mechanical thrombectomy predicts dramatic neurological recovery in ischaemic stroke patients. Eur Stroke J. 2020;5(4):362-369. doi:10.1177/2396987320933384pt_PT
dc.identifier.doi10.1177/2396987320933384pt_PT
dc.identifier.issn2396-9881
dc.identifier.issn2396-9873
dc.identifier.urihttp://hdl.handle.net/10400.16/2623
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSAGE Publicationspt_PT
dc.relation.publisherversionhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7856584/pt_PT
dc.subjectIschaemic strokept_PT
dc.subjectsystolic blood pressurept_PT
dc.subjectthrombectomypt_PT
dc.titleSpontaneous systolic blood pressure drop early after mechanical thrombectomy predicts dramatic neurological recovery in ischaemic stroke patientspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceEnglandpt_PT
oaire.citation.endPage369pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage362pt_PT
oaire.citation.titleEuropean Stroke Journalpt_PT
oaire.citation.volume5pt_PT
person.familyNameFernandes de Gabriel
person.givenNameDenis
person.identifier.ciencia-id1F1C-1282-CD8B
person.identifier.orcid0000-0002-6275-8656
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication5de941f8-e042-4e88-a061-ef53d8a2d231
relation.isAuthorOfPublication.latestForDiscovery5de941f8-e042-4e88-a061-ef53d8a2d231

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