Management of Elevated Blood Pressure After Stroke Thrombectomy for Anterior Circulation

Kexin Wu,1,2 Zhencheng Xiong,3,4 Yasuo Ding1,2 1Postgraduate School, Dalian Medical University, Dalian, People’s Republic of China; 2Department of Neurosurgery, Taizhou People’s Hospital, Taizhou, People’s Republic of China; 3Institute of Medical Technology, Peking University Health Science Center, Beijing, People’s Republic of China; 4Peking University Third Hospital, Beijing, People’s Republic of ChinaCorrespondence: Yasuo DingDepartment of Neurosurgery, Taizhou People’s Hospital, Taizhou, People’s Republic of ChinaEmail doctordys@126.comAbstract: Thrombectomy is superior to intravenous thrombolysis for patients with large vessel occlusion in acute ischemic stroke, but nearly half of the patients still experience poor functional outcomes. Elevated blood pressure (BP) is widely observed in acute ischemic stroke, and BP may be one of the modifiable parameters that can potentially influence the outcomes; however, only observational studies exist to support current guidelines, and the recommended range for BP after thrombectomy is too wide to meet the clinical requirement. Randomized controlled trials are therefore needed to better understand the relationship between BP and outcomes after thrombectomy. In this review, we introduce the current management of BP after thrombectomy and several aspects of postthrombectomy BP management that should be resolved in future clinical trials.Keywords: acute ischemic stroke, mechanical thrombectomy, blood pressure, hypertension, outcomes