Blood Pressure Goals and Clinical Outcomes after Successful Endovascular Therapy: A Multicenter Study.

BACKGROUND: Elevated systolic blood pressure (SBP) after successful revascularization via endovascular therapy (EVT) is a known predictor of poor outcome. However, the optimal SBP goal following EVT is still unknown. OBJECTIVE: To compare functional and safety outcomes between different SBP goals after EVT with successful revascularization (SR). METHODS: An international multicenter study that included 8 comprehensive stroke centers. Patients with anterior circulation LVO who were treated with EVT and achieved SR were included. SR was defined as mTICI (modified Thrombolysis in Cerebral Ischemia) 2b-3. Patients were divided into three groups based on SBP goal in the first 24 hours after EVT. Inverse probability of treatment weighting (IPTW) propensity analysis was used to assess the effect of different SBP goals on clinical outcomes. RESULTS: A total of 1019 patients were included. On IPTW analysis, the SBP goal =140 mm Hg, SBP < 140 mmHg was associated with a higher likelihood of good functional outcome, lower odds of sICH and lower odds of requirement for hemicraniectomy compared to SBP goal <180 mmHg. INTERPRETATION: SBP goals <140 and <160 mmHg following successful revascularization with EVT appear to be associated with better clinical outcomes than SBP <180 mmHg. This article is protected by copyright. All rights reserved.