Blood Pressure Management after Stroke Thrombectomy

Previous trials of intensive blood pressure control (systolic blood pressure [SBP] <140 mm Hg) after mechanical thrombectomy for acute ischemic stroke have shown no benefit, and some have even suggested harm from excessive lowering. However, whether tailoring BP management to reperfusion status might improve outcomes remains uncertain.

In this open-label trial with blinded endpoint assessment at 11 Spanish stroke centers, investigators compared usual care (SBP target, ≤180 mm Hg) with reperfusion-based management: 100–140 mm Hg for patients with complete or near-complete reperfusion and 140–160 mm Hg for those with incomplete reperfusion. The analysis included 440 patients (mean age, 75) enrolled over 4 years.