Zhang Bing, Zhou Yihan, Zhang Xiaoxi, Li Yunke, Zhao Yang, Song Lili, Yang Pengfei, Zhang Yongwei, Liu Jianmin
Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China,
Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Cerebrovasc Dis. 2024 Dec 16:1-7. doi: 10.1159/000543043.
There remains a lack of consensus among physicians regarding the blood pressure (BP) management strategy for acute ischemic stroke patients; this study sought to determine current practice patterns and extension of consensus among stroke physicians after publications of several randomized controlled trials (RCTs).
An online survey of stroke clinicians registered to the Oriental Conference of Interventional Neurovascology (OCIN) platform and Enhanced Control of Hypertension and Thrombectomy Stroke Study (ENCHANTED2/MT) trail collaborators was conducted to investigate the BP management strategy after mechanical thrombectomy (MT). The survey was sent out in March 2024, extracted within 1 month, and then analyzed comprehensively using descriptive statistics.
A total of 351 available responses were collected and analyzed. These participants mostly come from tertiary-level hospitals (90.6%) in 31 provinces in China. During MT, the most popular a BP target was 140-160 mm Hg (36.5%, 128/351) and 120-140 mm Hg (26.8%, 94/351). For patients achieved successful reperfusion, those who achieved expanded treatment in cerebral infarction (eTICI) 3 were expected to maintain BP target of 120-140 mm Hg (56.7%, 199/351) or <120 mm Hg (27.1%, 95/351), while eTICI 2b were wished to 120-140 mm Hg (45.3%, 159/351) or 140-160 mm Hg (38.5%, 135/351). For patients who achieved unsuccessful reperfusion, the most selected BP target was 140-160 mm Hg (40.7%, 143/351). In brief, clinical doctors from China with different experiences have different views on the goals of BP management.
The survey highlights inter-institutional variability among stroke experts regarding the optimal BP target for acute ischemic stroke. While a majority of institutions have established standardized protocols for post-MT BP management, further prospective randomized trials are warranted to determine the optimal BP target.
医生们对于急性缺血性中风患者的血压管理策略仍缺乏共识；本研究旨在确定在几项随机对照试验（RCT）发表后，中风医生的当前实践模式以及共识的扩展情况。
对注册在东方介入神经血管学会议（OCIN）平台的中风临床医生以及强化高血压控制与血栓切除术治疗中风研究（ENCHANTED2/MT）试验的合作者进行了一项在线调查，以调查机械取栓术（MT）后的血压管理策略。该调查于2024年3月发出，在1个月内收回，然后使用描述性统计进行综合分析。
共收集并分析了351份有效回复。这些参与者大多来自中国31个省份的三级医院（90.6%）。在MT期间，最受欢迎的血压目标是140 - 160毫米汞柱（36.5%，128/351）和120 - 140毫米汞柱（26.8%，94/351）。对于实现成功再灌注的患者，那些实现脑梗死扩展治疗（eTICI）3级的患者预期将血压目标维持在120 - 140毫米汞柱（56.7%，199/351）或<120毫米汞柱（27.1%，95/351），而eTICI 2b级的患者希望维持在120 - 140毫米汞柱（45.3%，159/351）或140 - 160毫米汞柱（38.5%，135/351）。对于未实现成功再灌注的患者，最常选择的血压目标是140 - 160毫米汞柱（40.7%，143/351）。简而言之，来自中国的不同经验的临床医生对血压管理目标有不同看法。
该调查突出了中风专家在急性缺血性中风最佳血压目标方面的机构间差异。虽然大多数机构已经建立了MT后血压管理的标准化方案，但仍需要进一步的前瞻性随机试验来确定最佳血压目标。
