Abstract Details

Title Blood Pressure Variability Post Mechanical Thrombectomy And Outcomes

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-006

Objective To investigate the effect of Blood Pressure (BP) variability on patient outcomes in the 24-hour time period following mechanical thrombectomy (MT) for large vessel occlusion (LVO).

Background Limited data exists on BP management in LVO patients who receive MT. While some studies demonstrate higher maximum SBP correlating with poor outcome, few studies exist on blood pressure variability and its effect on outcome. We sought to investigate the association of BP variability post-MT and functional outcome and mortality.

Design/Methods This was a retrospective chart review of 108 patients receiving MT during a 3-year time period. SBP, DBP, and Mean Arterial Pressure (MAP) were recorded for 24 hours following MT. The maximum, minimum, mean and variations from the mean were calculated for SBP, DBP and MAP. Demographic information as well as outcome data including mortality, symptomatic bleed, infarct volume, and Modified Rankin Score (mRS) at discharge and 90 days were recorded.

Results Total of 108 patients were evaluated, of which 47/108 received IV rtPA and 83/108 had successful MT (TICI 2B or higher). Bleeds were seen in 42/108 and symptomatic bleeds (NIH increase >4) in 12/108 patients. Maximum SBP (p=0.03) had a significant effect in predicting 90-day mortality and DBP variability of 10-20mmHg (p=0.05) had a significant effect in predicting discharge mRS.

Conclusions Data for BP management in patients who undergo MT is limited and typically focuses on SBP. Our study demonstrates that maximum SBP as well as DBP variability in the 24-hour time period following MT is independently associated with poor functional outcome in LVO patients. Further large prospective trials are warranted to identify whether stricter control of blood pressure variability with lower SBP and DBP will improve outcomes.

Authors/Disclosures
Phong T. Vu, MD (West Virginia University) PRESENTER	Dr. Vu has nothing to disclose.
Jessica Frey, MD (West Virginia University)	The institution of Dr. Frey has received research support from Tourette Association of America.
Ashley Petrone	No disclosure on file
Yasser Kabbani, MD	No disclosure on file
Swarna Rajagopalan, MD (Cooper University Healthcare)	Dr. Rajagopalan has nothing to disclose.

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