Efficacy and Safety of Ultra-early Intensive Hypotension after Mechanical Thrombectomy in Patients with Acute Anterior Circulation Ischemic Stroke

MA Lijuan; WU Yin; LI Guangzong

doi:10.3969/j.issn.1002-3429.2023.09.021

Abstract：Objective To investigate the efficacy and safety of ultra-early intensive hypotension after mechanical thrombectomy in patients with acute anterior circulation ischemic stroke(AACIS).Methods A total of 102 patients with AACIS who received mechanical thrombus removal from January 2020 to October 2022 were selected as the research subjects,and were divided into observation group and control group by odd-even grouping method,with 51 cases in each group.The control group received routine hypotension after operation,and the observation group received ultra-early intensive hypotension after operation.The clinical efficacy,blood pressure control before and after operation,serum indexes[paraoxonase-1(PON-1),lipoprotein-associated phosphesterase A2(Lp-PLA2),neuron-specific enolase(NSE)],severity of cerebral ede-ma,National Institutes of Health Stroke Scale(NIHSS)score and prognostic factors between the two groups were compared.Results The total effective rate was94.12%(48/51)in the observation group and90.20%(46/51)in the control group,suggesting no significant difference(P＞0.05).At 24 and 48 h after operation,systolic blood pressure,mean arterial pres-sure and the severity of cerebral edema in the observation group were lower than those in the control group(P＜0.05).At 24 h after operation,the serum PON-1 level in the two groups was higher than that before operation,while the levels of Lp-PLA2 and NSE were lower than those before operation(P＜0.05),but there was no statistical significance between the two groups(P＞0.05).At 24 h,48 h and90 d after operation,NIHSS score in the two groups was lower than that before op-eration(P＜0.05),but there was no statistical significance between the two groups(P＞0.05).There was no significant difference in the incidence of symptomatic craniocerebral hemorrhage,cerebrovascular re-occlusion,excellent and good rate of prognosis and mortality at 90 days after surgery between the two groups(P＞0.05).Conclusion Ultra-early intensive hypo-tension after mechanical thrombectomy in patients with AACIS can effectively control blood pressure in a short period of time,alleviate cerebral edema,improve the neurological function of patients,and have a certain safety.