• Andreas Ranft, Sebastian Berger, Martin Schubert, Silke Wunderlich, Tobias Boeckh-Behrens, Gerhard Schneider, and Alexander Hapfelmeier.
• Department of Anaesthesiology and Intensive Care, Technical University of Munich, School of Medicine and Health, Munich, Germany. Electronic address: andreas.ranft@tum.de.
• J Clin Anesth. 2024 Oct 28; 99: 111665111665.

Study ObjectiveBlood pressure drops during endovascular treatment of acute ischemic stroke have been associated with worse outcomes for stroke patients. We aimed to evaluate this observation in our patient population.DesignRetrospective study.SettingUniversity hospital.PatientsRecords from patients who underwent endovascular treatment of acute ischaemic stroke under general anaesthesia at a university hospital from 2017 to 2020 were screened. 586 patients aged 78 years (interquartile range [IQR] 67-84) with a mean National Institutes of Health Stroke Scale score of 15 (IQR 8-19) were included.InterventionsNone.MeasurementsGood functional outcome was defined as a three-month modified Rankin Scale (mRS) value between 0 and 2, or a mRS value less than or equal to the pre-stroke baseline.Main ResultsIn addition to well-established predictors, blood pressure before reperfusion was found to be associated with good functional outcomes. Per five minutes that systolic arterial pressure spent below 140 mmHg, the odds of good outcome decreased by 11.1 %.ConclusionsIn this retrospective study of general anaesthesia for endovascular stroke therapy, blood pressure drops during the intervention were associated with reduced odds of a good functional outcome three months later. Before a clinical recommendation can be made, a prospective study must clarify effective and safe target ranges of blood pressure support and augmentation.Copyright © 2024. Published by Elsevier Inc.

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