ABSTRACT NUMBER: ESOC2026A434 BLOOD PRESSURE MANAGEMENT IN PATIENTS RECEIVING RESCUE STENTING AFTER FAILED ENDOVASCULAR TREATMENT IN LARGE VESSEL OCCLUSION ACUTE ISCHEMIC STROKE: A MULTI-CENTER REGISTRY

Abstract Background and aims Rescue stenting (RS) has emerged as a bailout strategy after failed reperfusion during endovascular treatment. Optimal blood pressure (BP) management after RS remains unclear. Our aim is to evaluate the association of BP levels and blood pressure variability (BPV) during the first 24 hours after RS with short-term and long-term patient outcomes. Methods We performed a retrospective analysis of an international registry where data from adult patients who underwent either RS or rescue angioplasty after failed endovascular treatment were collected. Patients who received RS, with large vessel occlusion (LVO) and at least four BP measurements in the first 24 hours were included. Results RS was performed in 437 patients (40.5% female, mean age 67.1±13 years). Admission median National Institutes of Health Stroke Scale score was 12 (IQR 7–18) and history of hypertension was present in 74.2% of patients. Μean Systolic BP (SBP) in the first 24 hours was 137.4 ± 14.6 mmHg. Higher values of BPV (coefficient of variation, standard deviation, average real variability and successive variation) were associated with lower odds for mRS 0–2 at 90 days (adjusted odds ratio ranging from 0.929 [0.882, 0.977] to 0.953 [0.926, 0.980] per ten units increase). No associations were found between any SBP measure and death, sICH as well neurological deterioration at 24 hours. Conclusions In our study higher BPV was associated with worse clinical outcomes in stroke patients treated with RS as bailout therapy after failed reperfusion. No association was shown between mean, maximum, minimum and delta SBP and clinical outcomes. Conflict of interest Aikaterini Anastasiou. nothing to disclose, , Alex Brehm. nothing to disclose,