Characteristics of Cerebral Autoregulation After Mechanical Thrombectomy and Its Relationship With Prognosis

Abstract

Aims

To investigate the characteristics of dynamic cerebral autoregulation (dCA) in patients after mechanical thrombectomy (MT) and the relationship between dCA and prognosis.

Methods

In this prospective study, 89 and 158 patients were enrolled in the MT and non-MT groups, respectively. Both groups underwent dCA measurements within 3 days after stroke. The transfer function parameter, phase difference (PD), and gain were used to quantify dCA. A favorable outcome was defined as a modified Rankin Scale score ≤ 2 at 90 days. The collateral score was used to reflect the collateral reserve capacity.

Results

MT was associated with better PD in both the affected and unaffected sides. In the MT group, the PD of the affected side was an independent predictor of favorable outcomes (odds ratio [OR] 0.927, 95% confidence interval [CI] 0.885–0.970; p < 0.001). The area under the receiver operating characteristic curve for predicting favorable outcomes of the PD on the affected side was 0.759 (95% CI, 0.654–0.864; p < 0.001). Further, good collaterals were independently associated with better PD.

Conclusions

MT has a positive effect on dCA during the acute phase of stroke. For patients undergoing MT, dCA is a reliable indicator for predicting prognosis and may be an intervention target to improve outcomes.