ArticleStroke2019
Frequency of Blood-Brain Barrier Disruption Post-Endovascular Therapy and Multiple Thrombectomy Passes in Acute Ischemic Stroke Patients.
Article in Stroke, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00009243 (Evaluation, Pathogenesis, and Treatment of Patients With or at Risk for Cerebrovascular Disease), which is not on this map. Cited by 29 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluation, Pathogenesis, and Treatment of Patients With or at Risk for Cerebrovascular Disease (A Natural History/Disease Pathogenesis Protocol)
Who cites it
29 citing papers in PubMed, 5 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Safety outcomes in endovascular treatment versus best medical management for basilar artery occlusion acute ischemic stroke: A systematic review and meta-analysis of randomized trials.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Pooled it
- Endovascular thrombectomy plus intravenous thrombolysis versus endovascular thrombectomy alone for large ischemic stroke.Acta neurologica Belgica · 2026Pooled it
- Hyperintense acute reperfusion marker and gadolinium leakage in ocular structures in stroke: a systematic review.Neuroradiology · 2025Pooled it
- Per-pass analysis of recanalization and good neurological outcome in thrombectomy for stroke: Systematic review and meta-analysis.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2022Pooled it
- CSF enhancement on post-contrast fluid-attenuated inversion recovery images; a systematic review.NeuroImage. Clinical · 2020Pooled it
- Tirofiban on First-Pass Recanalization in Acute Stroke Endovascular Thrombectomy: The OPTIMISTIC Randomized Clinical Trial.JAMA network open · 2025Trial
- Epigenetic Regulation of the NET Formation-Blood-Brain Barrier Axis in Ischemic Stroke: Mechanisms, Therapeutic Targets and Translational Perspectives.Neurology international · 2026Review
- Early Post-Thrombectomy MRI Markers: Temporal Evolution and Association With Reperfusion and Clinical Outcome.Neurology · 2025Article
- Preserving Blood-Brain Barrier Integrity in Ischemic Stroke: a Review on MSCs-sEVs Content and Potential Molecular Targets.Molecular neurobiology · 2025Review
- Aging, vascular dysfunction, and the blood-brain barrier: unveiling the pathophysiology of stroke in older adults.Biogerontology · 2025Review
- Radiomics-based machine learning model for predicting clinically ineffective reperfusion in acute ischaemic stroke patients after endovascular treatment.Frontiers in neurology · 2025Article
- Differential impact of deep intraparenchymal hyperdensities versus subarachnoid/cortical hyperdensities on futile reperfusion after mechanical thrombectomy: a propensity score-matched study.Frontiers in neurology · 2025Article
- Benefit of endovascular treatment for primary versus secondary medium vessel occlusion: A multi-center experience.CNS neuroscience & therapeutics · 2024Article
- Clinical Applications of Dual-Energy Computed Tomography for Acute Ischemic Stroke.Stroke (Hoboken, N.J.) · 2024Review
- Blood-brain barrier disruption mediates the association between cerebral small vessel disease and clinical outcome after stroke: a secondary analysis of the Lesion Evolution in Stroke and Ischemia on Neuroimaging study.Frontiers in stroke · 2024Article
- Possible Occurrence of Delayed Leukoencephalopathy Following Acute Ischemic Stroke With Large-Vessel Occlusion.Stroke (Hoboken, N.J.) · 2024Article
- Post-ischemic hyperemia following endovascular therapy for acute stroke is associated with lesion growth.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2023Article
- Hemorrhagic Conversion of Acute Ischemic Stroke.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2023Review
- Nanotechnology in Stroke: New Trails with Smaller Scales.Biomedicines · 2023Review
- Ipsilateral blooming of microbleeds after Hyperintense Acute Reperfusion Marker sign in an ischemic Stroke patient, a case report.BMC neurology · 2022Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
Background and Purpose- The high prevalence of hyperintense acute reperfusion marker (HARM) seen after endovascular therapy is suggestive of blood-brain barrier disruption and hemorrhage risk and may be attributable to multiple thrombectomy passes needed to achieve recanalization. Methods- Patients with acute stroke were included if they were screened from January 2015 through February 2019, received an acute ischemic stroke diagnosis involving the anterior circulation, treated with or without IV tPA (intravenous tissue-type plasminogen activator), consented to the NINDS Natural History Study, and imaged with a baseline magnetic resonance imaging before receiving endovascular therapy. Consensus image reads for HARM and hemorrhagic transformation were performed. Good clinical outcome was defined as 0-2 using the latest available modified Rankin Scale score. Results- Eighty patients met all study criteria and were included in the analyses. Median age was 65 years, 64% female, 51% black/African American, median admit National Institutes of Health Stroke Scale=19, 56% treated with IV tPA, and 84% achieved Thrombolysis in Cerebral Infarction score of 2b/3. Multiple-pass patients had significantly higher rates of severe HARM at 24 hours (67% versus 29%; P=0.001), any hemorrhagic transformation (60% versus 36%; P=0.04) and poor clinical outcome (67% versus 36%; P=0.008). Only age (odds ratio, 1.1; 95% CI, 1.01-1.12; P=0.022) and severe HARM at 24 hours post-endovascular therapy were significantly associated with multiple passes (odds ratio, 7.2; 95% CI, 1.93-26.92; P=0.003). Conclusions- In this exploratory study, multiple thrombectomy passes are independently associated with a significant increase in blood-brain barrier disruption detected at 24 hours. Patients with HARM post-endovascular therapy had a >7-fold increase in the odds of having multiple- versus single-pass thrombectomy. Clinical Trial Registration- URL: https://www.clinicaltrials.gov. Unique identifier: NCT00009243.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.