Article Figures & Data
Figures
- Fig 1.
Receiver operating characteristic curves for changes in MAP before modified TICI 2b/3 reperfusion. Curves are shown for the effect of the lowest MAP on 90-day mRS 0–2 (A) and for the relationship between mRS 3–6 and an absolute MAP drop (B) and percentage MAP drop (C). The curves are labeled with pressures (A and B, in millimeters of mercury) and percentages (C). The cutoffs that were independent predictors of outcome in binary regression models are shown with bold type and open block arrows. AUC indicates area under the curve.
- Fig 2.
Rates of good neurologic outcome (90-day mRS of 0–2) by baseline NIHSS score and the lowest MAP measured before modified TICI 2b/3 reperfusion. Subdividing the NIHSS groups into 4 MAP categories yielded subgroups of similar size (n = 18–26).
Tables
- Table 1:
Univariate analysis of baseline characteristics, procedural variables, and outcomes associated with 90-day mRS > 2a
All Patients (n = 256b) 90-Day mRS 0–2 (n = 152) 90-Day mRS >2 (n = 104) P Value Demographics Age (yr) 65.2 ± 15.4 61.5 ± 15.1 70.7 ± 14.1 <.01c Male sex 123 (48%) 76 (50%) 47 (46%) .49 Current smoker 48 (19%) 30 (20%) 18 (17%) .61 Hypertension 179 (70%) 102 (67%) 77 (74%) .23 Diabetes mellitus 58 (23%) 35 (23%) 23 (22%) .86 Dyslipidemia 92 (36%) 55 (36%) 37 (36%) .92 Atrial fibrillation 95 (37%) 49 (32%) 46 (44%) .06c Stroke features Baseline NIHSS 17 (13–22) 15 (11–19) 20 (17–24) <.01c ASPECTS 8 (7–9) 9 (7–9) 7 (6–9) <.01c Occlusion site ICA terminus 46 (18%) 18 (12%) 28 (27%) <.01c MCA M1 158 (72%) 98 (64%) 60 (58%) .27 Last healthy to puncture (min) 295 (219–457) 281 (208–460) 305 (236–449) .34 IV tPA given 113 (44%) 71 (47%) 42 (41%) .35 Intraprocedural management Stent retriever 189 (74%) 115 (76%) 74 (72%) .44 Procedure time (min) 62 (41–88) 60 (41–81) 66 (40–91) .23 Vasopressor use 134 (52%) 75 (49%) 59 (57%) .24 Outcomes Parenchymal hemorrhage 19 (7%) 4 (3%) 15 (14%) <.01c Final infarct volume (cm3) 20.5 (7.3–60.0) 13.4 (5.4–35.6) 30.6 (17.4–111) <.01 90-day mRS 2 (1–4) Mortality 31 (12%) 31 (30%) Note:—M1 indicates the sphenoidal segment of middle cerebral artery.
↵a Results are shown as mean ± SD, median (interquartile range), or number (percentage).
↵b Not all patients had data available for ASPECTS (n = 243), minutes from last known healthy to groin puncture (n = 211), or final infarct volume (n = 217).
↵c Variables with P < .1 added to the multivariate models.
- Table 2:
Intraprocedural hemodynamic characteristicsa and their association with 90-day mRS > 2
All Patients (n = 256) 90-Day mRS 0–2 (n = 152) 90-Day mRS > 2 (n = 104) P Valueb Systolic blood pressure Baseline (mm Hg) 158 (135–176) 156 (134–173) 160 (137–180) .137 Lowest before mTICI 2b/3 (mm Hg)c 117 (103–132) 118 (105–135) 115 (99–124) .047 Absolute drop (mm Hg)d 35.5 (17–56) 30.0 (11–51) 41.5 (24–63) .004 % Pressure drope 22.8% (12–34) 21.4% (9–32) 27.6% (16–37) .002 Mean arterial pressure Baseline (mm Hg) 107 (95–120) 107 (94–118) 107 (95–123) .473 Lowest before mTICI 2b/3 (mm Hg) 79 (71–89) 81 (72–92) 77 (68–85) .01 Absolute drop (mm Hg)d 24.7 (13–39) 23.8 (11–31) 26.7 (16–42) .008 % Pressure drope 23.3% (13–34) 22.1% (12–31) 25.6% (18–37) .004 Note:—mTICI indicates modified TICI.
↵a Reported as median (interquartile range) unless otherwise noted.
↵b Mann-Whitney U test.
↵c Obtained from the systolic component of the lowest observed MAP prior to mTICI 2b/3 reperfusion.
↵d Calculated as the baseline pressure minus the lowest pressure before mTICI 2b/3.
↵e Calculated as the absolute pressure drop divided by the baseline pressure.
Variable OR (95% CI) P Value Age 1.05 (1.02–1.07) .001 Atrial fibrillation 1.09 (0.55–2.15) .805 Baseline NIHSS 1.16 (1.09–1.24) <.001 ASPECTS 0.80 (0.65–0.97) .023 ICA terminus occlusion 2.50 (1.14–5.50) .022 Parenchymal hemorrhage 5.06 (1.30–19.7) .020 Lowest MAP (per 10-mm Hg drop below 100 mm Hg)b 1.28 (1.01–1.62) .043
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