Related Experiment Video
Updated: Aug 14, 2026
09:21
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Individualized vs Standard Blood Pressure Control During Thrombectomy for Ischemic Stroke: The DETERMINE Randomized
Benjamin Maïer1,2,3,4,5, Benjamin Gory6,7, Russell Chabanne8
1Neurology Department, Hôpital Paris Saint-Joseph, France.
Neurology
|August 12, 2026
Summary
Individualized blood pressure management during mechanical thrombectomy for ischemic stroke did not improve functional outcomes. Standard blood pressure targets showed similar efficacy and safety compared to personalized approaches.
Area of Science:
- Neurology
- Cardiology
- Interventional Radiology
Background:
- Current mechanical thrombectomy (MT) guidelines use standardized blood pressure (BP) targets.
- The effectiveness of individualized BP control during MT for ischemic stroke is not well-established.
- This study addresses the need for evidence on personalized BP management in MT.
Purpose of the Study:
- To evaluate if individualized BP control during MT improves functional outcomes at 90 days.
- To compare the efficacy and safety of individualized versus standard BP management in acute ischemic stroke patients undergoing MT.
- To determine if a personalized approach to BP management during MT offers benefits over a one-size-fits-all strategy.
Main Methods:
- A multicenter, randomized clinical trial involving 433 patients with acute ischemic stroke and large vessel occlusion.
- Patients were assigned to either an individualized BP group (MAP within 10% of baseline) or a control group (systolic BP 140-180 mm Hg).
- The primary outcome was favorable functional outcome (modified Rankin Scale 0-2) at 90 days; safety outcomes included hemorrhage and mortality.
Main Results:
- No significant difference in favorable functional outcomes at 90 days between the individualized (44.2%) and control (48.8%) BP groups (aOR, 0.82; 95% CI 0.54-1.24; p=0.34).
- Mortality at 90 days and rates of symptomatic intracranial hemorrhage were similar between the two groups.
- Mean BP levels and BP variability during the procedure did not significantly differ between the individualized and control groups.
Conclusions:
- Individualized BP management during MT for anterior large vessel occlusion stroke did not lead to better functional outcomes at 90 days compared to standard BP management.
- The study provides Class II evidence that both approaches yield similar functional outcomes.
- Current standard BP management strategies appear adequate for patients undergoing MT for anterior circulation ischemic stroke.
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