Comparison of Invasive and Non-Invasive Blood Pressure Measurements During Mechanical Thrombectomy for Acute Ischemic Stroke Under General Anesthesia – A Pilot Study.
Date
2025-07-15
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Abstract
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.
Description
The dataset consists of raw physiological recordings obtained from 30 adult patients with acute ischemic stroke who underwent mechanical thrombectomy under general anesthesia. Blood pressure was measured simultaneously using two modalities: continuous invasive monitoring via a radial artery catheter (IBP), with data recorded at 5-second intervals, and intermittent non-invasive oscillometric monitoring (NIBP) using an upper-arm cuff placed on the contralateral limb, with measurements taken every 5 minutes. The dataset includes paired values of systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) collected throughout the endovascular procedures. A total of 481 matched IBP and NIBP readings were recorded. Each data entry contains a timestamp, anonymized patient identifier, corresponding SBP, DBP, and MAP values from both modalities, and additional procedural metadata such as the timing of arterial access (door-to-groin time) and classification of readings according to hemodynamic state (e.g., hypotension). Data points with physiologically implausible values or excessive missingness were excluded according to predefined criteria. The dataset is stored in spreadsheet format and is organized to facilitate reproducibility, statistical analysis, and potential integration into larger data repositories or multicenter collaborations.
Keywords
acute ischemic stroke, mechanical thrombectomy, blood pessure, invasive blood pressure monitoring, non-invasive blood pressure monitoring
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CC0 1.0 Universal
Research funding institutions
This research was funded in whole or in part by the National Science Centre, Poland (NCN; grant number 2024/08/X/NZ5/00815).
Type
raw dataset