Highlights
- •Optimal blood pressure management in acute phase after thrombectomy may improve the outcomes.
- •Higher blood pressure variability has been associated with poor outcomes.
- •A target Systolic blood pressure < 160 in the first 24 h after thrombectomy may improve the outcomes.
Abstract
Endovascular treatment of acute ischemic stroke (AIS) and mechanical thrombectomy
(MT) is proven as a safe and effective novel treatment for emergent large vessel occlusion
in the anterior cerebral circulation. However, there are still many unanswered questions
on peri and post-procedural management including blood pressure (BP) control. The
current guidelines recommend maintaining BP <180/105 mmHg in the first 24 h after
MT. However, recent studies suggest that maintaining BP levels at lower levels in
the first 24 h after successful revascularization have been associated with favorable
functional outcome, reduced mortality rate, and hemorrhagic complications. Not only
absolute BP but also its variation in the first 24 h after MT have been associated
with neurological outcomes. Evidence on the effect of BP variability (BPV) after MT
in AIS even though limited, it does indicate the association of the higher BPV in
the first 24 h after MT and poor functional outcomes in AIS. In this review, we will
discuss the current literature on BP management in the first 24 h after MT and the
impact of BPV in the first 24 h after MT.
Keywords
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Article info
Publication history
Published online: September 13, 2020
Accepted:
September 11,
2020
Received in revised form:
September 10,
2020
Received:
June 8,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
