Flow restoration during mechanical thrombectomy for large vessel occlusion is associated with an immediate reduction of systemic blood pressure.

Managing blood pressure in patients with large vessel occlusion affects infarct size and clinical outcomes. We examined how restoring blood flow impacts systemic blood pressure during mechanical thrombectomy. Patients with large vessel occlusion in the anterior circulation undergoing mechanical thrombectomy between June 2016 and January 2018 were screened. We included those treated under local anesthesia or conscious sedation and analyzed standardized anesthesia protocols to assess systolic and diastolic blood pressure levels throughout the procedure. The primary outcome was the change of blood pressure, compared 5 min before versus 5 min after the last recanalization attempt. Successful reperfusion was defined as Thrombolysis in Cerebral Infarction score ⩾ 2b. Of 134 patients, 117 (87%) achieved successful angiographic reperfusion, showing a notable systolic blood pressure drop 5 min after flow restoration (10.2 ± 14.6 vs 3.24 ± 8.65 mm Hg, Flow restoration was associated with an immediate reduction of systolic blood pressure values in patients undergoing mechanical recanalization under local anesthesia or conscious sedation. This suggests a complex interplay between endovascular stroke therapy and cardiovascular hemodynamics.

Déclaration de conflit d'intérêts

Declaration of conflicting interestThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: AAK: The corresponding author reports no disclosures.CB: The Co-author reports no disclosures.LM: The Co-author reports no disclosures.HG: The Co-author reports no disclosures.GB: The Co-author reports no disclosures.SK: The Co-author reports no disclosures.TF: The Co-author reports no disclosures.CH: The Co-author reports no disclosures.MI: The Co-author reports no disclosures.JF: The Co-author reports personal fees from Consultant for Microvention, Stryker, Cerenovus, Acandis, Penumbra and Medtronic outside the submitted work. He is a member of the Executive Board of the scientific societies DGNR and ESMINT.FF: The Co-author reports no disclosures.