Evidence map›Paper›PMID 33472269›Full record

ArticleSeminars in neurology2021

Blood Pressure Management Before, During, and After Endovascular Thrombectomy for Acute Ischemic Stroke.

Adam de Havenon, Nils Petersen, Ali Sultan-Qurraie, Matthew Alexander, Shadi Yaghi, Min Park, Ramesh Grandhi, Eva Mistry

Open access · greenAbstract read
In one paragraph

Article in Seminars in neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.9field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 1 country.

Adam de HavenonDepartment of Neurology, University of Utah, Salt Lake City, Utah.
Nils PetersenDepartment of Neurology, Yale University, New Haven, Connecticut.
Ali Sultan-QurraieDepartment of Neurology, University of Washington, Valley Medical Center, Seattle, Washington.
Matthew AlexanderDepartment of Radiology, University of Utah, Salt Lake City, Utah.
Shadi YaghiDepartment of Neurology, New York University, New York, New York.
Min ParkDepartment of Neurosurgery, University of Virginia, Charlottesville, Virginia.
Ramesh GrandhiDepartment of Neurosurgery, University of Utah, Salt Lake City, Utah.
Eva MistryDepartment of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee.
University of Utah · USNew York University · USUniversity of Virginia · USValley Medical Center · USVanderbilt University Medical Center · USYale University · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Utah Center for Clinical and Translational ScienceUL1TR002538 · NCATS · UNIVERSITY OF UTAH · PI HESS, RACHEL, MAJERSIK, JENNIFER JUHL · 2018 to 2022
$26.0M
UT StrokeNet Administrative SupplementU24NS107228 · NINDS · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI Jennifer Juhl Majersik · 2018 to 2026
$3.0M
Treatment Targets for Inflamed Intracranial Atherosclerosis on Vessel Wall MRIK23NS105924 · NINDS · YALE UNIVERSITY · PI DE HAVENON, ADAM H. · 2019 to 2023
$988k
Precision blood pressure management after endovascular stroke therapy based on real-time autoregulation measurementsK23NS110980 · NINDS · YALE UNIVERSITY · PI PETERSEN, NILS H. · 2020 to 2024
$951k
NCATS NIH HHS UL1 TR001863NCATS NIH HHS UL1 TR002538NINDS NIH HHS K23 NS105924NINDS NIH HHS K23 NS110980NINDS NIH HHS U24 NS107228
6 · The paper itself

Abstract

There is an absence of specific evidence or guideline recommendations on blood pressure management for large vessel occlusion stroke patients. Until randomized data are available, the periprocedural blood pressure management of patients undergoing endovascular thrombectomy can be viewed in two phases relative to the achievement of recanalization. In the hyperacute phase, prior to recanalization, hypotension should be avoided to maintain adequate penumbral perfusion. The American Heart Association guidelines should be followed for the upper end of prethrombectomy blood pressure: ≤185/110 mm Hg, unless post-tissue plasminogen activator administration when the goal is <180/105 mm Hg. After successful recanalization (thrombolysis in cerebral infarction [TICI]: 2b-3), we recommend a target of a maximum systolic blood pressure of < 160 mm Hg, while the persistently occluded patients (TICI < 2b) may require more permissive goals up to <180/105 mm Hg. Future research should focus on generating randomized data on optimal blood pressure management both before and after endovascular thrombectomy, to optimize patient outcomes for these divergent clinical scenarios.

Indexed as

Brain IschemiaEndovascular ProceduresIschemic StrokeStrokeBlood PressureHumansThrombectomyTissue Plasminogen ActivatorTreatment OutcomeTissue Plasminogen Activator

Identifiers

PMID33472269
PMCPMC8063274
OpenAlexW3126057952

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.