There is mounting evidence
linking extremely low admission BP levels with adverse early and late functional outcomes in patients presenting with ACI  and . AZD5363 purchase In addition the results of a recent randomized phase III trial showed that acute antihypertensive therapy causing mild BP reductions (3–6 mmHg) during the first 7 days of AIS was not related to better functional outcome or lower rates of cardiovascular events when compared to placebo. In contrast, stroke progression was increased by almost 50% in patients treated with antihypertensive therapy in comparison to the placebo group . The following therapeutic measures may be considered in patients with END caused by SCAEs: 1. Avoiding antihypertensive medications during the first 48 h of ACI (unless systolic
blood pressure/diastolic blood pressure > 220/120 mmHg). Early reocclusion may be the most common mechanism of early clinical fluctuation and worsening after thrombolytic therapy and intra-arterial procedures for acute ischemic stroke, NVP-BGJ398 chemical structure leading to poor clinic outcome and higher in-hospital mortality  and . Thrombolytic therapy has been demonstrated to be effective in acute stroke by dissolving the arterial occlusion and reestablishing tissue perfusion. However, the beneficial effect of tissue plasminogen activator (tPA)-induced recanalization may be eventually hampered by the occurrence of reocclusion  and . Early reocclusion occurs in 15–34% of AIS patients treated with iv-tPA achieving any initial recanalization, accounting for up 2/3 of deterioration
following improvement  and . Reocclusion can be detected in real-time using transcranial Doppler (TCD) monitoring , , Aspartate  and . Reocclusion is observed in 17% of patients, who undergo intra-arterial thrombolysis based on catheter angiographic surveillance . Reocclusion can also occur during or after catheter-based interventions . In particular, the prevalence of reocclusion occurring during and within an hour after intra-arterial reperfusion procedures (mechanical thrombectomy, thromboaspiration, intra-arterial thrombolysis) is 19% and 8%, respectively . Reocclusion in stroke patients appears to occur most in those with partial initial recanalization. These patients may be prone to repeated thrombosis and artery-to-artery reembolization particularly in the setting of a large vessel atherosclerosis  and . Another potential independent predictor of reocclusion is severe stroke given the fact that increased stroke severity as reflected by higher NIHSS-scores represents larger thrombus burden . Interestingly, Rubiera et al.