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

## TL;DR

This study shows that mechanical thrombectomy improves brain blood flow regulation and that this improvement is linked to better patient outcomes after stroke.

## Contribution

The study identifies dynamic cerebral autoregulation as a novel predictor of prognosis in patients who underwent mechanical thrombectomy.

## Key findings

- Patients who underwent mechanical thrombectomy showed better dynamic cerebral autoregulation on both affected and unaffected sides.
- Phase difference on the affected side was an independent predictor of favorable outcomes in MT patients.
- Good collateral circulation was independently associated with improved dynamic cerebral autoregulation.

## Abstract

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

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.

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.

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.

MT has a positive effect on dynamic cerebral autoregulation (dCA) at the acute phase of stroke. For MT patients, dCA is a reliable indicator for predicting the prognosis of patients and may be an intervention target to improve outcomes.