Blood Pressure Target in Acute Stroke to Reduce hemorrhaGe After Endovascular Therapy

Study Overview
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Brief Summary
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A randomized, multicenter study comparing two strategies: 1 / standard management of systolic blood pressure according to international recommendations (systolic blood pressure <185 mm Hg) versus 2 / intensive blood pressure management Systolic with a target <130 mm Hg.

Detailed Description
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Patients will be followed for 3 months: inclusion after reperfusion: clinical evaluation with NIHSS (National Institute of Health Stroke Score) score, measurement of blood pressure. within 24 hours after reperfusion: blood pressure measurements at 24 hours: measurement of blood pressure (T0 + 24 h and evaluation of the NIHSS score. Between 24 and 36 hours :cerebral scan (assessment of hemorrhagic transformations and cerebral infarction volumes). For some centers: Cerebral MRI without injection between H24 and H36 72 hours after reperfusion: Cerebral scanner in case of hyperdensity on the initial scanner 3 months after reperfusion: disability assessment by Rankin score

Official Title
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Comparison of Two Strategies for Blood Pressure Control in the Setting of Acute Ischemic Stroke to Reduce Cerebral Hemorrhage After Thrombectomy: Systolic Blood Pressure Target of Less Than 130 mmHg vs Less Than 185 mmHg, for 24 Hours Following Reperfusion, in Patients With Cerebral Infarction Due to Occlusion of the Anterior Circulation

Conditions
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Acute Stroke, Blood Pressure, Cerebral Hemorrhage

Intervention / Treatment
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* Other: Systolic blood pressure target < 130 mm Hg
* Other: Systolic blood pressure target < 185 mm Hg


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Intracranial Occlusion of internal carotid arteries and/or proximal middle cerebral (segment M1) diagnosis made on initial Imaging. Reperfusion after a thrombectomy procedure (defined by a 2b-3 TICI score -Thrombolysis In Cerebral Infarction- score). Exclusion Criteria: Per-procedure hemorrhagic complications (prior to reperfusion) Systolic blood pressure at baseline <130 mm Hg within one hour of recanalization Pre-existing stroke handicap defined by a Rankin score (modified scale, mRS)> 3 Hemodynamically significant carotid stenosis Occlusion of the isolated cervical carotid artery Known pregnancy Legal protection Non-affiliation to a social security scheme Refusal of the patient (or of his / her relatives in case of urgent inclusion)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intensive blood pressure management<br> | Other: Systolic blood pressure target < 130 mm Hg<br>* Adaptation of antihypertensive treatments to reach the Systolic blood pressure target < 130 mm Hg<br>|
| Active Comparator: Standard blood pressure management<br> | Other: Systolic blood pressure target < 185 mm Hg<br>* Adaptation of antihypertensive treatments to reach the Systolic blood pressure target < 185 mm Hg<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of patients with intracranial hemorrhagic complications | Rate of patients with intracranial hemorrhagic complications (Symptomatic or asymptomatic) on cerebral scan, evaluated with a double centralized blind reading | Scan performed between 24 and 36 hours after thrombectomy | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Acute Stroke, Blood Pressure, Cerebral Hemorrhage