Evidence map›Paper›PMID 38453701›Full record

SynthesisClinical neuroradiology2024

Intensive Blood Pressure Control After Endovascular Thrombectomy for Acute Ischemic Stroke: a Systematic Review and Meta-Analysis.

Mohamed Abuelazm, Yehya Khlidj, Ahmed A Ibrahim, Abdelrahman Mahmoud, Ahmed Mazen Amin, Ibrahim Gowaily, Ubaid Khan, Basel Abdelazeem, James Robert Brašić

Erratum issuedAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical neuroradiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Efficacy and Safety of Recombinant Human Prourokinase in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Pooled it
  2. Association of intensive blood pressure lowering with health-related quality of life after endovascular thrombectomy: a post-hoc analysis of the ENCHANTED2/MT trial.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026
    Trial
  3. Improving physiological monitoring and reporting standards in preclinical stroke research.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026
    Review
  4. Observational
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Mohamed AbuelazmFaculty of Medicine, Tanta University, Tanta, Egypt.
Yehya KhlidjFaculty of Medicine, University of Algiers, Algiers, Algeria.
Ahmed A IbrahimFaculty of Medicine, Menoufia University, Menoufia, Egypt. ahmedabdalaziz33@med.menofia.edu.eg.ORCID http://orcid.org/0000-0003-3669-5724
Abdelrahman MahmoudFaculty of Medicine, Minia University, Minia, Egypt.
Ahmed Mazen AminFaculty of Medicine, Mansoura University, Mansoura, Egypt.
Ibrahim GowailyFaculty of Medicine, Tanta University, Tanta, Egypt.
Ubaid KhanFaculty of Medicine, King Edward Medical University, Lahore, Pakistan.
Basel AbdelazeemDepartment of Cardiology, West Virginia University, West Virginia, USA.
James Robert BrašićSection of High-Resolution Brain Positron Emission Tomography Imaging, Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeOptimal clinical outcome with successful recanalization from endovascular thrombectomy (EVT) requires optimal blood pressure (BP) management. We aimed to evaluate the efficacy and safety of the intensive BP target (< 140 mm Hg) versus the standard BP target (< 180 mm Hg) after EVT for acute ischemic stroke.

methodsWe conducted a systematic review and meta-analysis synthesizing evidence from randomized controlled trials (RCTs) obtained from PubMed, Embase Cochrane, Scopus, and WOS until September 7th, 2023. We used the fixed-effect model to report dichotomous outcomes using risk ratio (RR) and continuous outcomes using mean difference (MD), with a 95% confidence interval (CI). PROSPERO ID: CRD42023463206.

resultsWe included four RCTs with 1559 patients. There was no difference between intensive BP and standard BP targets regarding the National Institutes of Health Stroke Scale (NIHSS) change after 24 h [MD: 0.44 with 95% CI (0.0, 0.87), P = 0.05]. However, the intensive BP target was significantly associated with a decreased risk of excellent neurological recovery (mRS ≤ 1) [RR: 0.87 with 95% CI (0.76, 0.99), P = 0.03], functional independence (mRS ≤ 2) [RR: 0.81 with 95% CI (0.73, 0.90), P = 0.0001] and independent ambulation (mRS ≤ 3) [RR: 0.85 with 95% CI (0.79, 0.92), P < 0.0001].

conclusionsAn intensive BP target after EVT is associated with worse neurological recovery and significantly decreased rates of functional independence and independent ambulation compared to the standard BP target. Therefore, the intensive BP target should be avoided after EVT for acute ischemic stroke.

Indexed as

Endovascular ProceduresIschemic StrokeThrombectomyBlood PressureHumansRandomized Controlled Trials as TopicCardiovascular diseaseClinical trialFunction recoveryIntracranial hemorrhageMeta-analysisStroke

Identifiers

PMID38453701
PMCPMC11339153

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.