Time-Dependent Relationship Between Blood Pressure And Functional Outcome In Acute Ischemic Stroke After Endovascular Thrombectomy

초록

Background and Aims: Research on functional outcomes in acute ischemic stroke patients with spontaneous SBP drops below 140 mmHg after EVT is limited, and the optimal time point for its strongest association with outcomes remains unclear. This study examines post-EVT SBP at different time points and its link to functional outcomes. Methods: This retrospective analysis included patients who underwent EVT for acute ischemic stroke with emergent large vessel occlusion. We examined blood pressure data from the time of arrival at the emergency department through 24 hours post-EVT. Patients were categorized based on whether their SBP spontaneously dropped below 140 mmHg at different time points (immediately after EVT vs. within one hour after stabilization following EVT). We assessed factors associated with a good functional outcome, defined as a modified Rankin Scale (mRS) of 0-2, 3-months post-stroke Results: Among the 349 patients, 45.0% had a mean SBP < 140 mmHg immediately after EVT. Among the 237 patients who did not receive antihypertensive intervention immediately after EVT, 50.6% had a mean SBP < 140 mmHg within one hour after stabilization following EVT. Patients with a mean SBP < 140 mmHg after stabilization following EVT were significantly more likely to achieve good functional outcomes (4.62 [2.11 – 10.12], p < 0.001). In contrast, SBP < 140 mmHg immediately after EVT was not significantly associated with good outcomes in multivariable analysis (1.40 [0.78 – 2.54], p = 0.264). Conclusions: Our findings suggest that SBP <140 mmHg after stabilization following EVT, rather than immediately post-procedure, is significantly associated with good functional outcomes.