Titre
Blood-brain barrier disruption is associated with increased mortality after endovascular therapy
Type
article
Institution
Externe
Périodique
Auteur(s)
Desilles, J. P.
Auteure/Auteur
Rouchaud, A.
Auteure/Auteur
Labreuche, J.
Auteure/Auteur
Meseguer, E.
Auteure/Auteur
Laissy, J. P.
Auteure/Auteur
Serfaty, J. M.
Auteure/Auteur
Lapergue, B.
Auteure/Auteur
Klein, I. F.
Auteure/Auteur
Guidoux, C.
Auteure/Auteur
Cabrejo, L.
Auteure/Auteur
Sirimarco, G.
Auteure/Auteur
Lavallee, P. C.
Auteure/Auteur
Schouman-Claeys, E.
Auteure/Auteur
Amarenco, P.
Auteure/Auteur
Mazighi, M.
Auteure/Auteur
Liens vers les personnes
ISSN
1526-632X
Statut éditorial
Publié
Date de publication
2013
Volume
80
Numéro
9
Première page
844
Dernière page/numéro d’article
51
Peer-reviewed
Oui
Langue
anglais
Notes
Desilles, Jean-Philippe
Rouchaud, Aymeric
Labreuche, Julien
Meseguer, Elena
Laissy, Jean-Pierre
Serfaty, Jean-Michel
Lapergue, Bertrand
Klein, Isabelle F
Guidoux, Celine
Cabrejo, Lucie
Sirimarco, Gaia
Lavallee, Philippa C
Schouman-Claeys, Elisabeth
Amarenco, Pierre
Mazighi, Mikael
eng
Comparative Study
Research Support, Non-U.S. Gov't
Neurology. 2013 Feb 26;80(9):844-51. doi: 10.1212/WNL.0b013e31828406de. Epub 2013 Jan 30.
Rouchaud, Aymeric
Labreuche, Julien
Meseguer, Elena
Laissy, Jean-Pierre
Serfaty, Jean-Michel
Lapergue, Bertrand
Klein, Isabelle F
Guidoux, Celine
Cabrejo, Lucie
Sirimarco, Gaia
Lavallee, Philippa C
Schouman-Claeys, Elisabeth
Amarenco, Pierre
Mazighi, Mikael
eng
Comparative Study
Research Support, Non-U.S. Gov't
Neurology. 2013 Feb 26;80(9):844-51. doi: 10.1212/WNL.0b013e31828406de. Epub 2013 Jan 30.
Résumé
OBJECTIVE: To evaluate the incidence, baseline characteristics, and clinical prognosis of blood-brain barrier (BBB) disruption after endovascular therapy in acute ischemic stroke patients. METHODS: A total of 220 patients treated with endovascular therapy between April 2007 and October 2011 were identified from a prospective, clinical, thrombolysis registry. All patients underwent a nonenhanced CT scan immediately after treatment. CT scan or MRI was systematically realized at 24 hours to assess intracranial hemorrhage complications. BBB disruption was defined as a hyperdense lesion on the posttreatment CT scan. RESULTS: BBB disruption was found in 128 patients (58.2%; 95% confidence interval [CI], 51.4%-64.9%). Cardioembolic etiology, high admission NIH Stroke Scale score, high blood glucose level, internal carotid artery occlusion, and use of combined endovascular therapy (chemical and mechanical revascularization) were independently associated with BBB disruption. Patients with BBB disruption had lower rates of early major neurologic improvement (8.6% vs 31.5%, p < 0.001), favorable outcome (39.8% vs 61.8%, p = 0.002), and higher rates of 90-day mortality (34.4% vs 14.6%, p = 0.001) and hemorrhagic complications (42.2% vs 8.7%, p < 0.001) than those without BBB disruption. By multivariable analysis, patients with BBB disruption remained with a lower rate of early neurologic improvement (adjusted odds ratio [OR], 0.28; 95% CI, 0.11-0.70) and with a higher rate of mortality (adjusted OR, 2.37; 95% CI, 1.06-5.32) and hemorrhagic complications (adjusted OR, 6.38; 95% CI, 2.66-15.28). CONCLUSION: BBB disruption has a detrimental effect on outcome and is independently associated with mortality after endovascular therapy. BBB disruption assessment may have a role in prognosis staging in these patients.
PID Serval
serval:BIB_2C3AF3F55E52
PMID
Date de création
2018-02-28T13:47:25.793Z
Date de création dans IRIS
2025-05-20T19:16:31Z