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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Fandler-Höfler, S; Heschl, S; Argüelles-Delgado, P; Kneihsl, M; Hassler, E; Magyar, M; Kainz, A; Berghold, A; Niederkorn, K; Deutschmann, H; Fazekas, F; Gattringer, T.
Single mean arterial blood pressure drops during stroke thrombectomy under general anaesthesia are associated with poor outcome.
J Neurol. 2020; 267(5):1331-1339 Doi: 10.1007/s00415-020-09701-x [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz
Fandler-Höfler Simon
Gattringer Thomas
Heschl Stefan
Co-Autor*innen der Med Uni Graz
Argüelles Delgado Placido Modesto
Berghold Andrea
Deutschmann Hannes
Fazekas Franz
Hassler Eva Maria
Kainz Andreas
Kneihsl Markus
Magyar Marton
Niederkorn Kurt

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We examined the influence of periprocedural blood pressure (BP), especially critical BP drops, on 3-month functional outcome in stroke patients undergoing mechanical thrombectomy (MT) under general anaesthesia (GA). We screened all patients with anterior circulation large vessel occlusion receiving MT under GA at our centre from January 2011 to June 2016 and selected those who had continuous invasive periinterventional BP monitoring. Clinical and radiological data were prospectively collected as part of an ongoing cohort study, monitoring data were extracted from electronic anaesthesia records. We used uni- and multivariable regression to investigate the association of BP values with unfavourable outcome, defined as modified Rankin Scale scores 3-6 3 months post-stroke. 115 patients were included in this study (mean age 65.3 ± 13.0 years, 55.7% male). Periinterventional systolic, diastolic, and mean arterial BP (MAP) values averaged across MT had no effect on outcome. However, single BP drops were related to unfavourable outcome, with absolute MAP drops showing the highest association compared to both systolic and relative BP drops (with reference to pre-interventional values). The BP value with the strongest association with unfavourable outcome was identified as an MAP ever < 60 mmHg (p = 0.01) with a pronounced effect in patients with poor collaterals. An MAP < 60 mmHg remained independently associated with poor functional outcome in multivariable analysis (p < 0.01). For patients undergoing MT under GA, single MAP drops < 60 mmHg are independently related to unfavourable 3-month outcome. Therefore, every effort should be made to prevent periinterventional hypotensive episodes, especially below this threshold.

Find related publications in this database (Keywords)
Large vessel occlusion
Blood pressure
Neurocritical care
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