Background

Elevated blood pressure (BP) is common among patients presenting with acute ischemic stroke due to large vessel occlusions. The literature is inconsistent regarding the association between admission BP and outcome of mechanical thrombectomy (MT). Moreover, it is unclear whether the first line thrombectomy strategy (stent retriever [SR] versus contact aspiration [CA]) modifies the relationship between BP and outcome.

Methods

This is a post hoc analysis of the ASTER (Contact Aspiration Versus Stent Retriever for Successful Revascularization) randomized trial. BP was measured prior to randomization in all included patients. Co-primary outcomes included 90-day functional independence (modified Rankin Scale [mRS] 0-2) and successful revascularization (modified Treatment in Cerebral Ischemia [mTICI] 2b-3). Secondary outcomes included symptomatic intracerebral hemorrhage (sICH) and parenchymal hemorrhage (PH) within 24 hours.

Results

A total of 381 patients were included in the present study. Mean (SD) systolic BP (SBP) and diastolic BP (DBP) were 148 (26) mm Hg and 81 (16) mm Hg, respectively. There was no association between SBP or DBP and successful revascularization or 90-day functional independence. Similarly, there was no association between admission SBP or DBP with sICH or PH. Subgroup analysis based on the first-line thrombectomy strategy revealed similar results with no heterogeneity across groups.

Conclusion

Admission BP was not associated with functional, angiographic or safety outcomes. Results were similar in both CA and CA groups.

中文翻译：

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入院血压和血管内治疗结果：ASTER试验的二级分析

背景

由于大血管阻塞而导致急性缺血性卒中的患者血压升高（BP）很常见。关于入院BP与机械血栓切除术（MT）结局之间的关联，文献不一致。此外，尚不清楚一线血栓切除术策略（支架摘除术[SR]与接触抽吸术[CA]）是否能改变BP与预后之间的关系。

方法

这是对ASTER（成功进行血运重建的接触抽吸与支架取回器）随机试验的事后分析。在所有入组患者中，在随机分组之前测量血压。共同主要预后包括90天的功能独立性（改良的Rankin量表[mRS] 0-2）和成功的血运重建（改良的脑缺血治疗[mTICI] 2b-3）。次要结果包括24小时内的症状性脑出血（sICH）和实质性出血（PH）。

结果

本研究共纳入381名患者。平均（SD）收缩压（SBP）和舒张压（DBP）分别为148（26）mm Hg和81（16）mm Hg。SBP或DBP与成功的血运重建或90天的功能独立性之间没有关联。同样，入院SBP或DBP与sICH或PH之间也没有关联。基于一线血栓切除策略的亚组分析显示相似的结果，各组之间没有异质性。

结论

入院BP与功能，血管造影或安全性结果无关。CA和CA组的结果相似。