Abstract WP145: Quantifying Blood Pressure Variability Within the First Hour Following Endovascular Therapy

Abstract

Background: Blood pressure variability (BPV) during the first 24 hours following endovascular therapy is associated with poor functional outcome. However, to be a viable treatment target, BPV needs to be recognized very quickly after large vessel recanalization. Hypothesis: We hypothesized that high frequency arterial line data will facilitate BPV quantification within 1 hour of large vessel recanalization, which will correlate with 24-hour BPV. Methods: This single-center retrospective cohort included acute stroke patients who underwent endovascular therapy during 2022 for large vessel occlusion. Eligible patients had an invasive radial artery catheter for continuous blood pressure monitoring during and after endovascular therapy. Systolic and diastolic blood pressure were recorded at 1Hz. For both systolic and diastolic, BPV was calculated over one hour and 24 hours following endovascular therapy using four techniques: (1) standard deviation, (2) coefficient of variation, (3) successive variation, and (4) average real variation. Correlation between the two time windows was evaluated for each BPV metric. Results: Of 198 patients who underwent EVT during the study time frame, 108 had the required arterial line data. BPV metrics calculated based on systolic blood pressure were at least moderated correlated between the 1-hour and 24-hour window. When calculated based on diastolic blood pressure, BPV metrics were strongly correlated between the 1-hour and 24-hour window ( Table ). Conclusions: With high frequency arterial line data, BPV, in particular diastolic variability can be reliably assessed within the first hour following large vessel recanalization. Given the previously observed relationship between BPV and functional outcome, future study is needed to explore the possibility of leveraging BPV as a treatment target during post-endovascular supportive care.