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--- mechanical_thrombectomy_for_acute_ischemic_stroke_treatment [2024/06/07 02:58] – created - external edit 127.0.0.1
+++ mechanical_thrombectomy_for_acute_ischemic_stroke_treatment [2025/07/04 11:59] (current) – administrador
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 ===== Mechanical thrombectomy for large vessel occlusion =====
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 ===== Blood Pressure Management =====
-There is an absence of specific [[evidence]] or [[guideline]] [[recommendation]]s on [[blood pressure]] [[management]] for [[acute large vessel occlusion treatment]] in [[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 for the Early Management of Patients With [[Acute Ischemic Stroke]] 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 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
+There is an absence of specific [[evidence]] or [[guideline]] [[recommendation]]s on [[blood pressure]] [[management]] for [[acute]] [[large vessel occlusion treatment]] in [[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 for the Early Management of Patients With [[Acute Ischemic Stroke]] 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 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
 ((de Havenon A, Petersen N, Sultan-Qurraie A, Alexander M, Yaghi S, Park M, Grandhi R, Mistry E. Blood Pressure Management Before, During, and After Endovascular Thrombectomy for Acute Ischemic Stroke. Semin Neurol. 2021 Jan 20. doi: 10.1055/s-0040-1722721. Epub ahead of print. PMID: 33472269.)).