ArticleAnnals of clinical and translational neurology2024
Blood-brain barrier profile pretreatment is associated with hemorrhagic transformation after endovascular reperfusion.
Article in Annals of clinical and translational neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Role of the WNT signalling pathway in physiological and pathological blood-brain barrier.Annals of medicine · 2026Review
- 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 · 2026Article
- Beyond Recanalization: Neurovascular Unit Protection and Precision Adjunctive Therapy for Ischemic Stroke in the Reperfusion Era.Biomolecules · 2026Review
- Article
- Astrocyte-Microglia Crosstalk in Post-Hemorrhagic Neurovascular Microenvironment: Mechanistic Nodes, Cross-Stroke Comparisons, and Therapeutic Reprogramming.Translational stroke research · 2026Review
- Blood-Brain Barrier Disruption Before Interhospital Transfer for Thrombectomy and Clinical Outcome.Neurology · 2026Article
- Review
- Article
- Disruption of the Blood-Brain Barrier Predicts Progression of Cerebral Small Vessel Disease White Matter Hyperintensities.Annals of neurology · 2026Article
- Predictive value of blood composite biomarkers for hemorrhagic transformation following mechanical thrombectomy in acute anterior circulation large vessel occlusion stroke patients.Frontiers in neuroscience · 2026Article
- Mfsd2a-Targeted Therapy for Ischemic Stroke: Mechanisms, Evidence, and Future Prospects.CNS neuroscience & therapeutics · 2025Review
- Impact of Collateral Circulation on Poststroke Epilepsy After Mechanical Thrombectomy for Large Vessel Occlusive Stroke: A Multicenter Cohort Study.European journal of neurology · 2025Article
- Research progress on the correlation between biological rhythms and the blood-brain barrier after ischemic stroke.Frontiers in neurology · 2025Review
- Analysis of risk factors for hemorrhagic transformation after mechanical thrombectomy in acute anterior circulation large vessel occlusion stroke and construction of a nomogram prediction model.Frontiers in neurologyArticle
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Authors and funding
25 authors.
Funding
Abstract
backgroundWhile advances in endovascular thrombectomy (EVT) have led to high reperfusion rates, most patients treated with EVT do not avoid disability. Post-reperfusion hemorrhagic transformation (HT) is a potential target for improving outcomes. This study examined pretreatment blood-brain barrier (BBB) disruption in tissue that would subsequently become part of the final infarct to evaluate its role in post-EVT HT.
methodsThis post hoc analysis of the FRAME study, which enrolled patients with anterior large vessel occlusion who received EVT within 6 hours of onset, included patients if they had successful pretreatment MRI perfusion weighted imaging (PWI) and underwent successful EVT. BBB disruption was measured as the percent signal change due to gadolinium leakage on the PWI source images prior to thrombectomy. Mean permeability derangement (MPD) was defined as the average of all voxels in the stroke core that are two standard deviations above normal. The primary outcome was hemorrhagic transformation with parenchymal hematoma (PH).
resultsIn total, 164 patients were included; mean age was 71 and 48% were female. PH occurred in 57 patients. Median MPD was 13.5% for patients with PH versus 3.6% for patients without (p < 0.0001). Elevated MPD was independently associated with PH with a 20% increased risk of PH for each 5% increase in MPD (OR 1.206; 95% CI 1.037:1.405; p = 0.0147, adjusted for NIHSS and procedure duration).
conclusionsEven in patients who are successfully recanalized in an early time window, pretreatment BBB disruption in regions that go on to infarct is associated with an increased risk of post-EVT HT.
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