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Angiography-Derived Autoregulation Targets After Thrombectomy

Lyman, K.; Thinzar, L. P.; Vargas, D.; Falcone, G. J.; Gilmore, E.; Kim, J. A.; Magid-Bernstein, J.; de Havenon, A.; Matouk, C. C.; Hebert, R.; Sheth, K. N.; Ortega-Gutierrez, S.; Petersen, N. H.

2026-08-17 neurology
10.64898/2026.08.13.26360389 medRxiv
Show abstract

Optimal blood pressure management after thrombectomy remains uncertain, and individualized autoregulation-based targets typically require continuous neuromonitoring. We developed an angiography-derived autoregulatory metric using intraprocedural data and applied it retrospectively to a single-center cohort of patients who underwent thrombectomy for acute stroke. From 62 patients with 3-month functional outcomes, greater time within the predicted autoregulatory range during the first 24 hours after thrombectomy was independently associated with improved outcome after adjustment for covariates (odds ratio per 10% increase, 1.86; 95% CI, 1.31-2.66; P = .0006). These findings support routine angiography as a potential source of early, patient-specific hemodynamic targets after thrombectomy.

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