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 have their clot successfully removed.

We want to test whether reducing blood pressure to a lower target than is currently recommended can improve outcomes in these patients. We are starting with a smaller study to gain information on whether it is possible to perform a larger definitive one and how best to plan it. Patients with stroke who have high blood pressure after successful thrombectomy will be assigned randomly (like flipping a coin) to a lower or higher blood pressure target. 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. We have already included 21 patients at our hospital, and look to expand the study to 4 additional Canadian hospitals to reach our target sample of 70 patients for this initial phase. These results will provide important information to plan our larger global study with the ultimate goal of reducing death and disability after a stroke.