Retrospective cohort study finds post-thrombectomy hypotension doubles in-hospital mortality in large-vessel stroke, highlighting the need for close haemodynamic monitoring.
Key Points
To evaluate the incidence, predictive clinical factors, and early neurological outcomes associated with post-procedural hypotension requiring vasopressor support following endovascular thrombectomy.
Retrospective single-centre study evaluating 201 consecutive adult patients undergoing endovascular thrombectomy for anterior-circulation large-vessel occlusion between January 2017 and January 2025.
Defined post-procedural hypotension as requiring continuous noradrenaline infusion within 24 hours of thrombectomy across general anaesthesia and conscious sedation cohorts.
Post-procedural hypotension developed in 27.4% (55/201) of patients, significantly increasing in-hospital mortality (50.9% vs. 20.5%, p < 0.001) and day-7 disability (common OR 2.57, 95% CI 1.40–4.72, p = 0.002).
Independent predictors of hypotension were baseline stroke severity (adjusted OR 1.11 per NIHSS point, 95% CI 1.04–1.19, p = 0.003) and active malignancy (adjusted OR 2.90, 95% CI 1.04–8.09, p = 0.042).
Each 10-minute delay in door-to-groin time increased hypotension risk (adjusted OR 1.10, 95% CI 1.03–1.18, p = 0.003), whereas anaesthesia type did not differ significantly (28.6% vs. 24.6%, adjusted OR 1.12, 95% CI 0.54–2.34, p = 0.766).
Cite This Study
Zielińska-Turek et al. (2026) studied this question.