Acute Blood Pressure Management After Ischemic Stroke

2010 ◽  
pp. 115-126 ◽  
Author(s):  
Venkatesh Aiyagari
Stroke ◽  
2012 ◽  
Vol 43 (2) ◽  
pp. 557-559 ◽  
Author(s):  
Erin McDonough Grise ◽  
Opeolu Adeoye ◽  
Christopher Lindsell ◽  
Kathleen Alwell ◽  
Charles Moomaw ◽  
...  

JAMA ◽  
2014 ◽  
Vol 311 (5) ◽  
pp. 469 ◽  
Author(s):  
Jeffrey L. Saver

2021 ◽  
pp. 239698732110008
Author(s):  
Min Chen ◽  
Dorothea Kronsteiner ◽  
Markus A Möhlenbruch ◽  
Meinhard Kieser ◽  
Martin Bendszus ◽  
...  

Background Optimal blood pressure is not well established during endovascular therapy of acute ischemic stroke. Applying standardized blood pressure target values for every stroke patient might be a suboptimal approach. Aim To assess whether an individualized intraprocedural blood pressure management with individualized blood pressure target ranges might pose a better strategy for the outcome of the patients than standardized blood pressure targets. Sample size: Randomization of 250 patients 1:1 to receive either standard or individualized blood pressure management approach. Methods and design We conduct an explorative single-center randomized controlled trial with a PROBE (parallel-group, open-label randomized controlled trial with blinded endpoint evaluation) design. In the control group, intraprocedural systolic blood pressure target range is 140–180 mmHg. The intervention group is the individualized approach, which is maintaining the intraprocedural systolic blood pressure at the level on presentation (±10 mmHg). Study outcomes: The primary endpoint is the modified Rankin scale assessed 90 days +/− 2 weeks after stroke onset, dichotomized by 0–2 (favorable outcome) to 3–6 (unfavorable outcome). Secondary endpoints include early neurological improvement, infarction size, and systemic physiology monitor parameters. Discussion An individualized approach for blood pressure management during thrombectomy could lead to a better outcome for stroke patients. The trial is registered at clinicaltrials.gov as ‘Individualized Blood Pressure Management During Endovascular Stroke Treatment (INDIVIDUATE)’ under NCT04578288.


2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Lin Zhu ◽  
Qinghong Wang ◽  
Cuncun Liu

Abstract: Objective: To investigate the management of perioperative target blood pressure in the treatment of acute ischemic stroke with intravenous thrombolytic bridging. Methods: Retrospective analysis of the blood pressure management and nursing experience of 36 patients with acute ischemic stroke who received endovascular treatment with bridge mode from November 2017 to January 2019 in our hospital. Through correct monitoring of basic blood pressure, rapid and stable blood pressure reduction before the bridge treatment, close cooperation during the operation, and close observation and treatment of postoperative blood pressure fluctuations, the patient’s blood pressure can be controlled within the target range. Results: The blood vessels of 36 patients were partially or completely recanalized after treatment. Clinical outcomes: Two cases died. After 90 days, 29 patients with good clinical outcomes were followed up, and 5 patients with poor clinical prognosis. Conclusion: Effective blood pressure management is a necessary measure in the perioperative period of bridging therapy for patients with acute ischemic stroke, which can reduce the postoperative complications of patients treated with bridging therapy, obtain good therapeutic effect and improve the prognosis of patients.


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