Most strokes occur from clots blocking vessels that supply blood flow to the brain. A large blockage in one of the main brain vessels is identified in up to 1/3 of patients presenting with stroke. Endovascular thrombectomy is a procedure that is effective at removing clots and restoring blood flow to the threatened brain tissue in such cases. However, even after successful thrombectomy, nearly half of these patients will die or will be left disabled. Higher blood pressures after this procedure are associated with a higher risk of poor outcome. However, lowering blood pressure with medications may harm the brain from reducing blood flow. As a result, doctors are uncertain regarding the best target blood pressure in stroke patients who are undergoing a procedure for clot removal from their brain vessels.
We want to test whether reducing blood pressure to a lower target can improve outcomes in these patients. Patients with stroke who have high blood pressure after clot removal will be assigned randomly (like flipping a coin) to lower or higher blood pressure targets. We will monitor how many patients are included in the study per year at each hospital and how well we are able to maintain the target blood pressure over 24 hours. We will also monitor the functional outcome of patients at 3 months. The study will be performed in many hospitals around the world, including Canada. The results of this study will inform us on whether controlling blood pressure following clot removal from a brain vessel can reduce disability from a stroke.
