Evidence map›Paper›PMID 36434858›Full record

ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2023

Good outcome associated with blood-brain barrier disruption and lower blood pressure after endovascular therapy.

Parth Upadhyaya, Amit Mehta, Marie Luby, Saeed Ansari, John K Lynch, Amie W Hsia, Lawrence L Latour, Yongwoo Kim

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Systolic blood pressure targets after successful endovascular thrombectomy: a network meta-analysis of randomized controlled trials.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Article
  2. Hyperemia detection on arterial spin labeling is associated with final infarct volume in stroke post-endovascular therapy.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2025
    Observational
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Parth UpadhyayaStroke Branch, National Institute of Neurological Diseases and Stroke, National Institutes of Health, 10 Center Dr., Building 10, Room B1D733, Bethesda, MD 20892, USA. Electronic address: parth.upadhyaya@utsouthwestern.edu.
Amit MehtaDepartment of Neurology, Georgetown University School of Medicine, Washington, D.C., USA.
Marie LubyStroke Branch, National Institute of Neurological Diseases and Stroke, National Institutes of Health, 10 Center Dr., Building 10, Room B1D733, Bethesda, MD 20892, USA.
Saeed AnsariDepartment of Neurology, Inova Health, Fairfax, VA, USA.
John K LynchStroke Branch, National Institute of Neurological Diseases and Stroke, National Institutes of Health, 10 Center Dr., Building 10, Room B1D733, Bethesda, MD 20892, USA.
Amie W HsiaStroke Branch, National Institute of Neurological Diseases and Stroke, National Institutes of Health, 10 Center Dr., Building 10, Room B1D733, Bethesda, MD 20892, USA; Department of Neurology, Georgetown University School of Medicine, Washington, D.C., USA; Comprehensive Stroke Center, MedStar Washington Hospital Center, Washington, D.C., USA.
Lawrence L LatourStroke Branch, National Institute of Neurological Diseases and Stroke, National Institutes of Health, 10 Center Dr., Building 10, Room B1D733, Bethesda, MD 20892, USA.
Yongwoo KimStroke Branch, National Institute of Neurological Diseases and Stroke, National Institutes of Health, 10 Center Dr., Building 10, Room B1D733, Bethesda, MD 20892, USA; Department of Neurology, Georgetown University School of Medicine, Washington, D.C., USA; Comprehensive Stroke Center, MedStar Washington Hospital Center, Washington, D.C., USA.

Funding

CLINICAL AND IMAGING CORE SUPPORT OF ACUTE STROKE RESEARCHZICNS003044 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI LATOUR, LAWRENCE · 2015 to 2025
$32.8M
NOVEL INSIGHTS INTO CEREBRAL ISCHEMIC PATHOPHYSIOLOGY IN HUMANSZIANS003043 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI LATOUR, LAWRENCE · 2009 to 2025
$19.5M
Intramural NIH HHS Z99 NS999999
6 · The paper itself

Abstract

objectivesTo evaluate the association between post-endovascular thrombectomy (EVT) blood-brain barrier (BBB) disruption on MRI or CT and average systolic blood pressure (SBP) with favorable 90-day functional outcome. Observational studies have found elevated SBP associated with worse outcomes post-EVT, while recent randomized trials found no difference in targeted BP reduction. There may be a subgroup of patients who benefit from targeted BP reduction post-EVT.

methodsThis is a single-center study of 1) anterior large vessel occlusion stroke patients treated with EVT from 2015 to 2021, 2) achieved mTICI grade 2b or 3. Hyperintense acute reperfusion marker (HARM), hemorrhagic transformation (HT), and midline shift at 3 h post-EVT and 24 h imaging were assessed independently by multiple raters. Binary logistic regression models were used to determine the association of post-EVT SBP with outcomes. BBB disruption was defined as HT or HARM on 3h post-EVT imaging.

resultsOf 103 patients, those with SBP 100-129 versus SBP 130-160 found no significant difference in favorable 90-day outcome (64% vs. 46%, OR 2.11, 95% CI 0.78-5.76, p=0.143). However, among 71 patients with BBB disruption, a significant difference in favorable outcome of 64% in SBP 100-129 vs. 39% in SBP 130-160 group (OR 5.93, 95% CI 1.50-23.45, p=0.011) was found. There was no difference in symptomatic ICH, 90-day mortality, midline shift (≥5 mm), and hemicraniectomy, between BP or BBB groups.

conclusionsBBB disruption on 3h post-EVT imaging and lower SBP was associated with favorable outcome. This imaging finding may guide targeted BP therapy and suggests need for a randomized control trial.

Indexed as

Brain IschemiaEndovascular ProceduresHypotensionStrokeBlood-Brain BarrierBlood PressureHumansThrombectomyTreatment OutcomeAcute strokeBlood brain barrier disruptionBlood pressureMRIPost-thrombectomy

Identifiers

PMID36434858
PMCPMC9825643

What OpenQuestion holds

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Registered trials

None linked

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.