Blood pressure management after mechanical thrombectomy is as crucial as reperfusion status in acute large vessel occlusion

 Hemodynamic Management After Thrombectomy in Acute Ischemic Stroke

Presenter: Jin Heon Jeong
Affiliation: Dong-A University Hospital, Korea, Republic of
Presentation Format: Poster Presentation (In-Person)

Tittle: Blood pressure management after mechanical thrombectomy is as crucial as reperfusion status in acute large vessel occlusion

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🔬 Presentation Overview

🩸 Clinical Context

Blood pressure variability (BPV) has emerged as a key factor influencing outcomes after mechanical thrombectomy (MT) in patients with acute large vessel occlusion (LVO). Its clinical impact may vary depending on pre-treatment collateral circulation.

🎯 Research Aim

This study examined whether post-procedural BPV affects 90-day functional outcomes, stratified by the hypoperfusion intensity ratio (HIR) obtained from perfusion MRI using RAPID software.

🔬 Study Framework

Patients with anterior circulation LVO who underwent emergency MT between 2020 and 2023 were included. All patients underwent pre-procedural perfusion MRI analyzed with RAPID software.

·         Outcomes were assessed using the modified Rankin Scale (mRS) at 90 days

·         Multivariate logistic regression models were applied

·         Median values were used to define BPV and HIR thresholds

·         Interaction between BPV and collateral status was analyzed using a composite variable

 

📈 Outcome Analysis

A total of 209 patients were evaluated.

·         BPV threshold: 8.27

·         HIR threshold: 0.37

Patients with both elevated BPV and high HIR showed a 78.3% incidence of poor functional outcomes, significantly higher than other subgroups.

🧠 Clinical Interpretation

These results reinforce the importance of blood pressure stability after thrombectomy, particularly in patients with impaired collateral circulation.


⚖️ Prognostic Comparison

High BPV combined with poor collateral flow independently predicted unfavorable outcomes (OR = 4.72), demonstrating a prognostic impact comparable to post-procedural reperfusion status (OR = 5.67).


🔮 Practice Implications

Maintaining stable and appropriate blood pressure in the intensive care unit following MT is essential for optimizing neurological recovery and long-term outcomes in acute LVO patients.

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👩‍⚕️ About the Speaker

Dr. Jin-Heon Jeong is a neurologist and neurocritical care specialist with extensive expertise in intensive care management and neurological emergencies. He graduated from Seoul National University College of Medicine and completed specialty training in neurology. Currently serving as Professor at Dong-A University and Director of the Neurocritical Care Unit.

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📅 Conference Details

Event: International Conference on Cardiology and Cardiovascular Science
Dates: March 26–28, 2026
Venue: Singapore & Online
Website: https://cardiology.miconferences.com/

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