Optimizing Blood Pressure Control After Thrombectomy for Stroke

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This clinical trial investigates the effects of different blood pressure management strategies in patients who have undergone endovascular thrombectomy for acute ischemic stroke. Participants will be randomly assigned to either an intensive blood pressure control group or a standard control group, with outcomes assessed by independent evaluators. The study aims to determine the optimal blood pressure target to improve functional recovery and quality of life after the procedure. Data will be collected on various health parameters, including neurological scores and blood pressure variability, over a multi-center study period.

Why it matters

Who can join: the full rules

\<Inclusion Criteria\>

1. Age ≥20 years
2. Acute ischemic stroke patients who underwent intraarterial thrombectomy for large vessel occlusion. (ICA, M1, M2, A1, P1, VA and BA)
3. Patients with successful recanalization after intraarterial thrombectomy (TICI 2b or TICI 3)
4. Patients with sustained systolic blood pressure (SBP) \<150 mm Hg on successive measurements obtained less than 10 minutes apart within 3 hours after reperfusion.
5. Patients with mean SBP \<150 mmHg within 2 hours after successful recanalization (two measurements ≥2 minutes apart).

\<Exclusion Criteria\>

1. Age \<20
2. Patients who failed recanalization of the intracranial artery after endovascular thrombectomy (modified TICI ≤ 2a).
3. Patients with systolic blood pressure ≥ 150 mmHg after successful recanalization.
4. Patients unable to receive antihypertensive medication post-thrombectomy or in whom the investigator believes aggressive blood pressure control could have adverse effects, such as increased risk of hemorrhage.
5. Patients who developed symptomatic intracranial hemorrhage before study enrollment, after successful recanalization.
6. Patients with contraindications to Phenylephrine.
7. Patients with contraindications to antihypertensive medications.
8. Patients with pre-stroke functional disability (modified Rankin Scale, mRS ≥3).
9. Patients with heart failure and reduced cardiac output, with an ejection fraction (EF) \<40%.
10. Patients with end-stage renal disease requiring renal replacement therapy, or chronic kidney disease stage 4 with an eGFR \<30 mL/min.
11. Patients currently taking monoamine oxidase (MAO) inhibitors.
12. Patients with persistent bradycardia with a heart rate \<45 bpm.
13. Pregnant patients.
14. Patients with severe medical or surgical comorbidities, including but not limited to: terminal cancer with life expectancy \<6 months, severe cardiac or aortic disease, severe hematologic disorders, advanced chronic heart failure, severe pneumonia, or sepsis.
15. Patients who do not consent to participate in the study.
16. Patients participating in another study that does not allow co-enrollment.
17. Patients whom the investigator deems unsuitable for study participation for any reason.

Where it's running

• Department of Neurology, Yonsei University College of Medicine
  Seoul, Seoul, South Korea Recruiting

Study contacts

• Study coordinator: Hyo Suk Nam, MD,PhD
• Email: hsnam@yuhs.ac
• Phone: 82-2-2228-1617

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.