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Related Experiment Videos

A decrease in blood pressure is associated with unfavorable outcome in patients undergoing thrombectomy under general

Kilian M Treurniet1, Olvert A Berkhemer1,2,3, Rogier V Immink4

  • 1Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.

Journal of Neurointerventional Surgery
|April 14, 2017
PubMed
Summary

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A drop in mean arterial pressure (MAP) during general anesthesia (GA) for acute ischemic stroke (AIS) thrombectomy is linked to poorer patient outcomes. Maintaining MAP is crucial for better functional recovery after stroke intervention.

Area of Science:

  • Neurology
  • Anesthesiology
  • Critical Care Medicine

Background:

  • Acute ischemic stroke (AIS) patients undergoing thrombectomy have high rates of dependency or mortality within 3 months.
  • Cerebral autoregulation impairment in AIS can increase vulnerability to mean arterial pressure (MAP) drops.
  • General anesthesia (GA) is used in some AIS thrombectomy procedures.

Purpose of the Study:

  • To investigate the impact of MAP fluctuations during GA on functional outcomes in AIS patients undergoing thrombectomy.
  • To determine if a decrease in MAP during intervention affects the modified Rankin Scale (mRS) score at 90 days.

Main Methods:

  • Subgroup analysis of patients from the MR CLEAN trial who underwent thrombectomy under GA.
  • Analysis of the difference between baseline MAP and average MAP during GA (ΔMAP) and lowest MAP during GA (ΔLMAP).
Keywords:
Blood PressureStrokeThrombectomy

Related Experiment Videos

  • Ordinal logistic regression used to assess the association between MAP changes and mRS outcome, adjusted for baseline variables.

    • Main Results:

    • A greater decrease in average MAP during GA compared to baseline (ΔMAP) was significantly associated with worse functional outcomes (adjusted common OR 0.95 per mm Hg).
    • An average MAP 10 mm Hg lower than baseline during GA reduced the odds of a good outcome (mRS shift) by 1.67 times.
    • No significant association was found between the lowest MAP during GA (ΔLMAP) and functional outcome.

    Conclusions:

    • A reduction in MAP during intervention under GA in AIS patients is associated with poorer functional outcomes.
    • Maintaining MAP during thrombectomy under GA may be important for improving patient recovery.