Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz

Logo MUG-Forschungsportal

Gewählte Publikation:

SHR Neuro Krebs Kardio Lipid

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 [OPEN ACCESS]
Web of Science PubMed PUBMED Central FullText FullText_MUG

 

Autor/innen der Med Uni Graz:
Argüelles-Delgado Placido M.
Berghold Andrea
Deutschmann Hannes
Fandler-Höfler Simon
Fazekas Franz
Gattringer Thomas
Hassler Eva Maria
Heschl Stefan
Kainz Andreas
Kneihsl Markus
Magyar Marton
Niederkorn Kurt
Altmetrics:

Dimensions Citations:

Plum Analytics:
Number of Figures: 3
| | |
Abstract:
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)
Stroke
Large vessel occlusion
Thrombectomy
Blood pressure
Anaesthesia
Neurocritical care
© Med Uni Graz Impressum