Blood pressure management in patients receiving rescue stenting after failed endovascular treatment in large vessel occlusion acute ischaemic stroke: a multicentre registry
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: Rescue stenting (RS) has emerged as a bailout strategy after failed reperfusion during endovascular treatment (EVT). Optimal blood pressure (BP) management after RS remains unclear. Our aim is to evaluate the association of BP levels and blood pressure variability (BPV) during the first 24 h after RS with short-term and long-term patient outcomes. METHODS: We performed a retrospective analysis of an international registry where data from adult patients who underwent either RS or rescue angioplasty after failed EVT were collected. Patients who received RS with large vessel occlusion and at least 4 BP measurements in the first 24 h were included. RESULTS: RS was performed in 437 patients (40.5% female, mean age 67.1 ± 13 years). Admission median National Institutes of Health Stroke Scale score was 12 (IQR 7-18) and history of hypertension was present in 74.2% of patients. Μean Systolic BP (SBP) in the first 24 h was 137.4 ± 14.6 mmHg. Higher values of BPV (coefficient of variation, standard deviation, average real variability and successive variation) were associated with lower odds for Modified Rankin Scale score 0-2 at 90 days (adjusted odds ratio ranging 0.55 [0.38, 0.79] to 0.99 [0.98, 0.99] per 10 units increase). No associations were found between any SBP measure and death, sICH as well as neurological deterioration at 24 h. CONCLUSION: In our study, higher BPV was associated with worse clinical outcomes in stroke patients treated with RS as bailout therapy after failed reperfusion. No association was shown between mean, maximum, minimum and delta SBP and clinical outcomes.
Source: European Stroke Journal
DOI: 10.1093/esj/aakag035
Authors: Aikaterini Anastasiou, Alex Brehm, Johannes Kaesmacher, Adnan Mujanovic, Marta de Dios Lascuevas, Tomas Carmona, Alfonso López-Frías, Blanca Hidalgo Valverde, Thanh N Nguyen, Mohamad Abdalkader, Piers Klein, Guillaume Thevoz, Patrik Michel, Bruno Bartolini, Marius Kaschner, Daniel Weiss, Andrea M Alexandre, Alessandro Pedicelli, Paolo Machi, Gianmarco Bernava, Shuntaro Kuwahara, Kazutaka Uchida, Jason Wenderoth, Anirudh Joshi, Grzegorz Karwacki, Manuel Bolognese, Agostino Tessitore, Sergio Lucio Vinci, Amedeo Cervo, Claudia Rollo, Ferdinand Hui, Aaisha Siddiqua Mozumder, Daniele Giuseppe Romano, Giulia Frauenfelder, Nitin Goyal, Vivek Batra, Violiza Inoa-Acosta, Christophe Cognard, Matúš Hoferica, Riitta Rautio, Daniel P O Kaiser, Johannes C Gerber, Julian Clarke, Michael R Levitt, Marcel N Wolf, Ahmed E Othman, Timo Uphaus, Luca Scarcia, Erwah Kalsoum, Diana Melancia, Diana Aguiar de Sousa, Maria Porzia Ganimede, Vittorio Semeraro, Flavio Giordano, Massimo Muto, Umesh Bonala, Anil M Tuladhar, Sjoerd F M Jenniskens, Victoria Hellstern, Ilka Kleffner, Paolo Remida, Susanna Diamanti, Leonardo Renieri, Elena Ballabio, Luca Valvassori, Wiesmann Martin, Frederic De Beukelaer, Vera Aebischer, Dang Hoang-Tho, Nikki Rommers, Mira Katan, Aristeidis H Katsanos, Marios-Nikos Psychogios
Institutions: University of Basel, University Hospital of Basel, University of Bern, University Hospital of Bern, Centre Hospitalier Universitaire de Tours, Vall d'Hebron Hospital Universitari, Hospital Clínico San Carlos, Boston University, Boston Medical Center, Centre Hospitalier Universitaire Vaudois, Düsseldorf University Hospital, Heinrich Heine University Düsseldorf, Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, Università Cattolica del Sacro Cuore, University Hospital of Geneva, Hyogo Medical University, UNSW Sydney, Prince of Wales Hospital, Luzerner Kantonsspital, Azienda Ospedaliera Universitaria Policlinico "G. Martino", University of Messina, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, University of Hawaiʻi at Mānoa, University of Hawaii System, Queen's Medical Center, University of Salerno, AOU San Giovanni di Dio e Ruggi d'Aragona, University of Tennessee Health Science Center, Semmes Murphey Foundation, Inserm, Centre Hospitalier Universitaire de Toulouse, Institut des Maladies Métaboliques et Cardiovasculaires, University of Turku, Turku University Hospital, University Hospital Carl Gustav Carus, Technische Universität Dresden, University of Washington, Johannes Gutenberg University Mainz, University Medical Center of the Johannes Gutenberg University Mainz, Centre Hospitalier Universitaire Henri-Mondor, Hôpitaux Universitaires Henri-Mondor, University of Lisbon, Unidade Local de Saúde de São José, Hospital de São José, Gulbenkian Institute for Molecular Medicine, Population Health Research Institute, McMaster University, Radboud University Nijmegen, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Klinikum Stuttgart, University Hospitals of the Ruhr-University of Bochum, Universitätsklinikum Knappschaftskrankenhaus Bochum, Azienda Ospedaliero-Universitaria Careggi, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Universitätsklinikum Aachen, RWTH Aachen University
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,400
OpenAlex ID: W7160832138