Instytut Nauk Medycznych / Institute of Medical Sciences

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Browsing Instytut Nauk Medycznych / Institute of Medical Sciences by Author "Wiącek, Marcin"

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    Comparison of Invasive and Non-Invasive Blood Pressure Measurements During Mechanical Thrombectomy for Acute Ischemic Stroke Under General Anesthesia – A Pilot Study.
    (2025-07-15) Wiącek, Marcin
    Introduction Intra-procedural hypotension during endovascular therapy (EVT) for acute ischemic stroke (AIS) is linked to poorer outcomes. Although continuous invasive blood pressure (IBP) monitoring could help guide timely clinical decisions, it is not routinely implemented during mechanical thrombectomy (MT) under general anesthesia. Objectives This study aimed to assess the agreement between continuous IBP and intermittent non-invasive blood pressure (NIBP) monitoring during EVT and to evaluate whether IBP monitoring impacts procedural timing. Patients and Methods In this prospective observational study, 30 patients undergoing MT for AIS under general anesthesia were enrolled. Blood pressure was simultaneously recorded using radial arterial lines (IBP) and oscillometric cuffs (NIBP, every 5 minutes). Bland–Altman plots were used to assess agreement. Clinically relevant discrepancies and door-to-groin (DTG) times were compared between patients with planned IBP and those without. Results A total of 481 matched BP readings were analyzed. Mean differences between IBP and NIBP for systolic blood pressure (SBP) and mean arterial pressure (MAP) were small (–0.64 mmHg and –0.99 mmHg, respectively), but agreement limits were wide (SBP: –40.6 to 39.4 mmHg; MAP: –28.5 to 26.5 mmHg). Diastolic pressure showed poor agreement (mean bias –7.64 mmHg). Significant SBP differences (≥20 mmHg) occurred in 41.0% of procedure time, and MAP discrepancies (>15 mmHg) in 29.6%. Median DTG times were similar between groups (41 vs. 38 minutes; p = 0.217). Conclusions Intermittent NIBP monitoring demonstrates limited agreement with continuous IBP, particularly under hypotensive conditions, and may fail to detect meaningful hemodynamic shifts. Importantly, the use of IBP does not appear to delay treatment initiation. These results support further investigation in larger studies.