Abstract 1122‐000123: Association of 24‐hour Blood Pressure Parameters Post‐Thrombectomy with Functional Outcomes According to Collateral Status

Introduction : Higher blood pressure (BP) most post mechanical thrombectomy (MT) can restore perfusion to the ischemic brain tissue depending on collateral status. We aim to determine the association of 24‐hour post‐MT BP parameters with the functional outcome depending on the pre‐MT collateral status. Methods : We performed a retrospective chart review of patients who underwent MT at a comprehensive stroke center from 7/2014 to 12/2020. The patients were divided into two groups (good versus bad) depending on collateral status. A board‐certified neuroradiologist, who was blinded to the clinical outcomes, used collateral grading scales of Mass ≥3 and modified‐Tan>50% to designate good collaterals on the pre‐MT CT Angiogram. A binary logistic regression analysis was performed, controlling for age, sex, NIHSS, ASPECTS≥6, TICI score≥2b, time to thrombectomy, LDL, Hemoglobin‐A1C, intravenous‐alteplase, with the 24‐hour post‐MT BP parameters as the predictors. The outcomes were good functional outcome (3‐month mRS≤2) and mortality. Results : 220 patients met the inclusion criteria. 24‐hour BP parameters of standard deviation (SD) SBP (OR, 1.16; 95% CI,1.01‐1.33; P 0.047) and maximum DBP (OR, 1.05; 95% CI,1.01‐1.09; P 0.036) had an association with a good functional outcome, while SD SBP (OR, 1.15; 95% CI,1.01‐1.31; P 0.045), coefficient variation (CV) SBP (OR, 1.19; 95% CI,1.01‐1.41; P 0.043), SBP range (OR, 1.04; 95% CI,1.01‐1.07; P 0.046), maximum DBP (OR, 0.95; 95% CI,0.91‐0.99; P 0.016), pulse pressure (OR, 1.09; 95% CI,1.02‐1.16; P 0.022) and SBP ≥140 (OR, 5.85; 95% CI,1.11‐30.85; P 0.038) had an association with mortality in patients with good collaterals according to Mass grading. 24‐hour BP parameters of SD SBP (OR, 1.13; 95% CI,1.04‐1.24; P 0.007), CV SBP (OR, 1.18; 95% CI,1.05‐1.32; P 0.006), SBP range (OR, 1.04; 95% CI,1.01‐1.06; P 0.008) and maximum DBP (OR, 0.97; 95% CI,0.94‐1; P 0.02) had an association with mortality in patients with good collaterals according to modified‐Tan grading. There was no such association in patients with bad collaterals Conclusions : Various 24‐hour BP parameters post‐MT are associated with a functional outcome or mortality in patients with good collaterals, unlike in patients with bad collaterals.