{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T03:54:10Z","timestamp":1771300450526,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T00:00:00Z","timestamp":1695600000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Mechanical thrombectomy (MT) has become standard treatment in acute ischemic stroke due to large vessel occlusion (LVO). However, optimal blood pressure (BP) management following successful recanalization remains unclear. We aim to investigate the association of strictly achieving BP targets of \u2264160\/90\u2009mmHg with the extent of neuronal loss and functional outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In patients prospectively enrolled in the Gutenberg\u2010Stroke\u2010Study (May 2018\u2013November 2019), BP was measured half\u2010hourly for 24\u2009h following MT. Based on achieving BP target of \u2264160\/90\u2009mmHg, patients with successful recanalization of LVO were divided into \u201clow\u2010BP\u201d group (BP \u2264\u2009160\/90\u2009mmHg) or \u201chigh\u2010BP\u201d group (BP\u2009&gt;\u2009160\/90\u2009mmHg). Neuronal loss was quantified by serum\u2010based measurement of neurofilament light chain (sNfL) after three days. BP groups and association of BP parameters with sNfL were investigated by correlation analyses and multiple regression modeling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 253 enrolled patients (mean age 73.1\u2009\u00b1\u200912.9\u2009years, 53.4% female), 165 met inclusion criteria. 21.2% (<jats:italic>n<\/jats:italic>\u2009=\u200935) strictly achieved \u201clow\u2010BP\u201d target. \u201clow\u2010BP\u201d was associated with unfavorable functional outcome at 90\u2010day follow\u2010up (aOR [95%CI]: 5.88 [1.88\u201318.32], <jats:italic>p<\/jats:italic>\u2009=\u20090.002) and decreased health\u2010related quality of life (mean EQ\u20105D\u2010index 0.45\u2009\u00b1\u20090.28 vs 0.63\u2009\u00b1\u20090.31, <jats:italic>p<\/jats:italic>\u2009=\u20090.009). sNfL levels were increased in \u201clow\u2010BP\u201d patients (median [IQR] 239.7 [168.4\u2013303.4] vs 118.8 [52.5\u2013220.5] pg\/mL, <jats:italic>p<\/jats:italic>\u2009=\u20090.026). Hypotensive episodes were more frequent in the \u201clow\u2010BP\u201d group (48.6% vs 29.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.031). sNfL level could identify patients who had experienced hypotensive episodes with high discriminative ability (AUC [95%CI]: 0.68 [0.56\u20130.78], <jats:italic>p<\/jats:italic>\u2009=\u20090.007).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Strict BP control (\u2264160\/90\u2009mmHg) within 24\u2009h following successful recanalization of LVO by MT is associated with increased neuronal injury, displayed by higher sNfL levels, and poorer functional outcome, potentially indicating hypotension\u2010induced neuronal loss during post\u2010MT phase.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51909","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T07:14:15Z","timestamp":1695626055000},"page":"2255-2265","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Strict blood pressure control following thrombectomy is associated with neuronal injury and poor functional outcome"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9462-3844","authenticated-orcid":false,"given":"Marianne","family":"Hahn","sequence":"first","affiliation":[{"name":"Department of Neurology and Focus Program Translational Neuroscience (FTN), Rhine main Neuroscience Network (rmn2) University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eyad","family":"Hayani","sequence":"additional","affiliation":[{"name":"Department of Neurology and Focus Program Translational Neuroscience (FTN), Rhine main Neuroscience Network (rmn2) University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynn","family":"Bitar","sequence":"additional","affiliation":[{"name":"Department of Neurology and Focus Program Translational Neuroscience (FTN), Rhine main Neuroscience Network (rmn2) University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonja","family":"Gr\u00f6schel","sequence":"additional","affiliation":[{"name":"Department of Neurology and Focus Program Translational Neuroscience (FTN), Rhine main Neuroscience Network (rmn2) University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Falk","family":"Steffen","sequence":"additional","affiliation":[{"name":"Department of Neurology and Focus Program Translational Neuroscience (FTN), Rhine main Neuroscience Network (rmn2) University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Protopapa","sequence":"additional","affiliation":[{"name":"Department of Neurology and Focus Program Translational Neuroscience (FTN), Rhine main Neuroscience Network (rmn2) University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Othman","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Bittner","sequence":"additional","affiliation":[{"name":"Department of Neurology and Focus Program Translational Neuroscience (FTN), Rhine main Neuroscience Network (rmn2) University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frauke","family":"Zipp","sequence":"additional","affiliation":[{"name":"Department of Neurology and Focus Program Translational Neuroscience (FTN), Rhine main Neuroscience Network (rmn2) University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0244-6116","authenticated-orcid":false,"given":"Klaus","family":"Gr\u00f6schel","sequence":"additional","affiliation":[{"name":"Department of Neurology and Focus Program Translational Neuroscience (FTN), Rhine main Neuroscience Network (rmn2) University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5526-0510","authenticated-orcid":false,"given":"Timo","family":"Uphaus","sequence":"additional","affiliation":[{"name":"Department of Neurology and Focus Program Translational Neuroscience (FTN), Rhine main Neuroscience Network (rmn2) University Medical Center of the Johannes Gutenberg University Mainz  Mainz 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