Autoregulation-Guided Blood Pressure Targets After Stroke Thrombectomy

BACKGROUND AND OBJECTIVES: The optimal blood pressure (BP) target after endovascular thrombectomy (EVT) remains elusive. The aim of our study was to assess the relationship between individualized autoregulation-based BP thresholds, secondary brain injury, and functional outcomes. METHODS: We conducted a prospective observational study of patients with acute ischemic stroke who underwent EVT. Simultaneous recordings of arterial BP and near-infrared spectroscopy were used to continuously monitor each patient's limits of autoregulation for up to 24 hours. Time outside limits of autoregulation was correlated with short-term clinical end points, radiographic biomarkers of secondary brain injury, and functional outcomes. RESULTS: < 0.001). DISCUSSION: Deviations from personalized BP targets were associated with an increased risk of secondary brain injury and worse functional outcomes. The study proposes autoregulation-oriented BP management as a promising strategy for improving recovery after ischemic stroke.