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Blood pressure variability and hemorrhagic transformation in patients with successful recanalization after endovascular recanalization therapy: A retrospective observational study.
- Source :
-
Annals of neurology [Ann Neurol] 2019 Apr; Vol. 85 (4), pp. 574-581. Date of Electronic Publication: 2019 Mar 06. - Publication Year :
- 2019
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Abstract
- Objective: Although blood pressure (BP) variability has been regarded as a risk factor for hemorrhagic transformation (HTF) after intravenous thrombolysis, its effect on HTF after endovascular recanalization therapy (ERT) remains to be elucidated. We aimed to study the relationship between BP variability and symptomatic intracerebral hemorrhage (sICH) after successful recanalization with ERT.<br />Methods: A total of 211 patients with acute ischemic stroke and successful recanalization (thrombolysis in cerebral infarction 2b or 3) after ERT were included between January 2013 and May 2017. The BP data following ERT was obtained over the first 24 hours using parameters including mean, maximum, minimum, difference between maximum and minimum, standard deviation, coefficient of variation, successive variations, and time rate (TR) of BP variation for systolic BP (SBP) and diastolic BP. sICH was defined as parenchymal hemorrhage type 2 with neurological deterioration of 4 points of more on the National Institute of Health Stroke Scale.<br />Results: Among the included patients, 20 (9.5%) developed sICH after successful ERT. The parameters linked with BP fluctuation over time were significantly related to sICH. After adjusting for confounders, the TR of SBP (per 0.1 mmHg/min increase) variation was independently associated with sICH (odds ratio = 1.71, 95% confidence interval = 1.013-2.886).<br />Interpretation: Time-related BP variability in the first 24 hours following successful ERT was more correlated with sICH than other absolute BP levels. This suggests that maintaining a stable BP may be an important factor in preventing sICH after successful ERT. Ann Neurol 2019;85:574-581.<br /> (© 2019 American Neurological Association.)
- Subjects :
- Aged
Aged, 80 and over
Brain Ischemia physiopathology
Brain Ischemia therapy
Catheterization adverse effects
Catheterization trends
Cerebral Hemorrhage etiology
Endovascular Procedures adverse effects
Female
Humans
Male
Middle Aged
Retrospective Studies
Stroke physiopathology
Stroke therapy
Blood Pressure physiology
Cerebral Hemorrhage diagnosis
Cerebral Hemorrhage physiopathology
Endovascular Procedures trends
Subjects
Details
- Language :
- English
- ISSN :
- 1531-8249
- Volume :
- 85
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Annals of neurology
- Publication Type :
- Academic Journal
- Accession number :
- 30761582
- Full Text :
- https://doi.org/10.1002/ana.25434