MASTERSTROKE
(2026)Objective
To determine whether augmented intra-procedural blood pressure (SBP 170 mmHg) during EVT under general anesthesia improves 90-day functional outcome compared with standard SBP target (140 mmHg).
Study Summary
• Median achieved SBP: 170 vs 141 mmHg.
• Primary 90-day mRS: 2 (1-4) vs 2 (1-4), P=0.49.
• sICH 2.1% vs 2.1%.
• 90-day mortality 15.2% vs 12.1% (NS).
• No benefit from restrictive SBP target 130-180 mmHg; supports current guideline BP management.
• Primary 90-day mRS: 2 (1-4) vs 2 (1-4), P=0.49.
• sICH 2.1% vs 2.1%.
• 90-day mortality 15.2% vs 12.1% (NS).
• No benefit from restrictive SBP target 130-180 mmHg; supports current guideline BP management.
Intervention
Augmented intra-procedural SBP 170 mmHg vs standard SBP 140 mmHg during EVT under GA (from procedure start until recanalization)
Inclusion Criteria
Australia and New Zealand. Stroke due to ICA/M1/M2 occlusion; EVT under general anesthesia; within 6 h of onset, or 6-24 h with perfusion mismatch.
Study Design
Arms: Augmented SBP 170 mmHg vs standard SBP 140 mmHg
Patients per Arm: Augmented n=280 vs Standard n=282 (total 562)
Outcome
• Median SBP: 170 vs 141 mmHg.
• Primary 90-day mRS: 2 (1-4) vs 2 (1-4), P=0.49.
• sICH: 2.1% vs 2.1%.
• 90-day mortality: 15.2% vs 12.1% (NS).
• Primary 90-day mRS: 2 (1-4) vs 2 (1-4), P=0.49.
• sICH: 2.1% vs 2.1%.
• 90-day mortality: 15.2% vs 12.1% (NS).