Article Text
Abstract
Introduction Despite substantial evidence of the association between intra-procedural blood pressure and functional outcome in patients undergoing mechanical thrombectomy (MT) under general anesthesia, little is known about the relationship between intraprocedural blood pressure and this outcome in patients undergoing MT under monitored anesthesia care (MAC).
Objective To investigate the association of different intraprocedural blood pressure parameters with functional outcome and the risk of hemorrhagic transformation (HT) in patients undergoing MT under MAC.
Methods We retrospectively reviewed patients who underwent MT between 11/1/2014 and 2/1/2017. Blood pressure was recorded at 3–5 min intervals during MT. We used logistic regression to measure the association for each of mean, maximum, and minimum systolic, diastolic, and mean arterial blood pressures with functional and safety outcomes.
Results 155 patients were included in the study. Seventy patients (45.2%) achieved a good outcome (mRS 0–2). The good outcome group was younger (60.7 vs 72.2 years; p<0.01) and had lower NIHSS score (13.7±6.3 vs 17.2±6; p<0.01). None of the intraprocedural blood pressure parameters correlated with the functional outcome. However, there was a trend towards a higher SBP in the poor outcome group (mean SBP 159.6±22.1 mm Hg vs 153±19.1 mm Hg; p=0.0508). Only mean SBP correlated with the risk of HT (OR for 10 mm Hg increment, 1.2; 95% CI 1.01–1.42).
Conclusion Our study did not show a significant correlation between intraprocedural blood pressure and functional outcome in patients who underwent MT under MAC.
However, we demonstrated a significant correlation between higher mean SBP and risk of HT.
Disclosures M. Anadani: None. S. Ajinkya: None. A. Alaweih: None. J. Vargas: None. A. Chatterjee: None. R. Turner: 6; C; Codman Consulting, Honorarium, Speaker Bureau, Research Funding; Covidien Consulting, Honorarium, Speaker Bureau; Penumbra Consulting, Honorarium, Speaker Bureau, Research Grants; Microvention Consult. M. Chaudry: 6; C; Codman Consulting, Honorarium, Speaker Bureau, Research Funding; Covidien Consulting, Honorarium, Speaker Bureau; Penumbra Consulting, Honorarium, Speaker Bureau, Research Grants; Microvention Consult. A. Turk: 6; C; Codman Consulting, Honorarium, Speaker Bureau, Research Funding; Covidien Consulting, Honorarium, Speaker Bureau; Penumbra Consulting, Honorarium, Speaker Bureau, Research Grants; Microvention Consult. A. Spiotta: 6; C; Penumbra Consulting, Honorarium, Speaker Bureau; Pulsar Vascular Consulting, Honorarium, Speaker Bureau; Microvention Consulting, Honorarium, Speaker Bureau, Research; Stryker Consulting, Honorarium.