Management of Blood Pressure During and After Recanalization Therapy for Acute Ischemic Stroke

Frontiers in Neurology

Jeffrey R. Vitt¹  J. Claude Hemphill¹  Michael Trillanes² 

[1] Department of Neurology, University of California, San Francisco, San Francisco, CA, United States;Department of Pharmaceutical Services, University of California, San Francisco, San Francisco, CA, United States;

关键词: acute ischemic stroke;    cerebral autoregulation;    hypertension;    ischemic penumbra;    embolectomy;   

DOI  :  10.3389/fneur.2019.00138

来源: DOAJ

【 摘 要 】

Ischemic stroke is a common neurologic condition and can lead to significant long term disability and death. Observational studies have demonstrated worse outcomes in patients presenting with the extremes of blood pressure as well as with hemodynamic variability. Despite these associations, optimal hemodynamic management in the immediate period of ischemic stroke remains an unresolved issue, particularly in the modern era of revascularization therapies. While guidelines exist for BP thresholds during and after thrombolytic therapy, there is substantially less data to guide management during mechanical thrombectomy. Ideal blood pressure targets after attempted recanalization depend both on the degree of reperfusion achieved as well as the extent of infarction present. Following complete reperfusion, lower blood pressure targets may be warranted to prevent reperfusion injury and promote penumbra recovery however prospective clinical trials addressing this issue are warranted.

【 授权许可】

Unknown