Blood pressure variability and short-term outcomes after mechanical thrombectomy in patients with acute ischemic stroke

Objectives: There is limited data evaluating effects of post-mechanical thrombec-tomy (MT) blood pressure (BP) control on short-term clinical outcomes in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO). We aim to investi-gate the association of BP variations, after MT, with stroke early outcomes. Materials and methods: A retrospective study was conducted on AIS patients with LVO under-going MT at a tertiary center over 3.5 years. Hourly BP data was recorded within the first 24-and 48-hours post-MT. BP variability was expressed as the interquartile range (IQR) of BP distribution. Short-term favorable outcome was defined as modi-fied Rankin scale (mRS) 0-3, discharge to home or inpatient rehabilitation facility (IRF). Results: Of the 95 enrolled subjects, 37(38.9%) had favorable outcomes at dis-charge and 8 (8.4%) died. After adjustment for confounders, an increase in IQR of systolic blood pressure (SBP) within the first 24 hours after MT revealed a signifi-cant inverse association with favorable outcomes (OR 0.43, 95% CI [0.19, 0.96], p = 0.039). Increased median MAP within the first 24 hours after MT correlated with favorable outcomes (OR 1.75, 95% CI [1.09, 2.83], p = 0.021). Subgroup analysis redemonstrated significant inverse association between increased SBP IQR and favorable outcomes (OR 0.48, 95% CI [0.21, 0.97], p = 0.042) among patients with successful revascularization. Conclusions: Post-MT high SBP variability was associ-ated with worse short-term outcomes in AIS patients with LVO regardless of recan-alization status. MAP values may be used as indicators for functional prognosis.