Einfluss des Ausmaßes einer Leukoaraiose und des Blutdrucks auf das klinische Ergebnis, die Mortalität und die Häufigkeit symptomatischer intrazerebraler Blutungen nach mechanischer Rekanalisation bei Patienten mit akutem Schlaganfall im anterioren Stromgebiet

Background and aims: We aimed to study theimpact of Leukoaraiosis (LA) and blood pressure (BP) on clinical outcome, mortality and symptomatic intracerebral haemorrhage (sICH) in acute ischemic stroke patients treated with mechanical thrombectomy (MT).

Methods: We analysed data retrospectively from 521 patients with anterior circulation occlusion treated with MT. LA was dichotomized in 0–2 (absent-to-moderate) versus 3–4 (moderate-to-severe) according to the van Swieten scale. Various systolic (SBP) and diastolic (DBP) BP parameters during the first 24 hours were collected. Multivariable logistic regressions were performed to identify predictors of a poor 90-day outcome, mortality and sICH.

Results:  LA was significantly associated with poor outcome (OR=3,2; p<0,001) and mortality (OR=3,19; p=0,008), but not sICH (p=0,19). Higher maximum SBP was significantly associated with poor outcome (OR per 10 mmHg increase=1,21; p=0,009) and lower mean DBP was a predictor of mortality (OR per 10 mmHg increase=0,53; p<0,001). In the univariate analysis high SBP variability was associated with poor outcome, mortality and sICH, but not in the multivariate model. There was no association between BP and sICH.

Conclusions: Severity of leukoaraiosis, SBP variability, high maximum SBP and low DBP are associated with either poor outcome or mortality in acute stroke patients undergoing MT. However, neither LA nor BP were associated with sICH in our cohort. Thus, mechanisms of the negative impact on outcome remain unclear. Further studies on impact of BP course and its mechanisms and interventions are needed to improve outcome in patients undergoing MT.


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