Carotid endarterectomy and blood-brain barrier permeability in subjects with bilateral carotid artery stenosis

Abstract Background The increased permeability of the blood–brain barrier (BBB) is related to the occurrence and development of diseases such as acute ischemic stroke, chronic ischemia, or small vessel disease. Patients with carotid artery stenosis have chronic ischemia. The exact effect of carotid...

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Main Authors: Changyu Lu, Chenyu Zhu, Wenjie Li, Huan Zhu, Qihang Zhang, Tong Liu, Tongyu Yang, Yan Zhang
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Chinese Neurosurgical Journal
Subjects:
Online Access:https://doi.org/10.1186/s41016-025-00398-3
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author Changyu Lu
Chenyu Zhu
Wenjie Li
Huan Zhu
Qihang Zhang
Tong Liu
Tongyu Yang
Yan Zhang
author_facet Changyu Lu
Chenyu Zhu
Wenjie Li
Huan Zhu
Qihang Zhang
Tong Liu
Tongyu Yang
Yan Zhang
author_sort Changyu Lu
collection DOAJ
description Abstract Background The increased permeability of the blood–brain barrier (BBB) is related to the occurrence and development of diseases such as acute ischemic stroke, chronic ischemia, or small vessel disease. Patients with carotid artery stenosis have chronic ischemia. The exact effect of carotid endarterectomy on the blood–brain barrier is still unclear. The aim of the study was to assess the effect of carotid endarterectomy on basic perfusion parameters and permeability surface area-product (PS). Methods The study included a total of 17 subjects (13 men), of which bilateral carotid artery stenosis was greater than 70%. All patients underwent unilateral carotid endarterectomy. Differences in the following computed tomography perfusion (CTP) parameters were compared before and after operation: cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP), and PS. PS acquired by CTP is used to measure the permeability of the BBB to contrast material. Results Before surgery, the operative side exhibited significantly lower CBF (p = 0.001) and prolonged MTT (p = 0.002) and TTP (p = 0.001) compared to the nonoperative side, while PS and CBV showed no significant differences. After carotid endarterectomy, only the operative side demonstrated improvements, with CBV increasing by 9.4%, MTT decreasing by 20.3%, TTP decreasing by 14.1%, and PS decreasing by 27.5% (all p < 0.01). No significant changes were observed on the nonoperative side. Conclusions Carotid endarterectomy augmented BBB permeability can be controlled by carotid endarterectomy in patients with carotid artery stenosis.
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spelling doaj-art-220106ee8a924046935cfa7799084ac32025-08-20T02:36:50ZengBMCChinese Neurosurgical Journal2057-49672025-06-011111710.1186/s41016-025-00398-3Carotid endarterectomy and blood-brain barrier permeability in subjects with bilateral carotid artery stenosisChangyu Lu0Chenyu Zhu1Wenjie Li2Huan Zhu3Qihang Zhang4Tong Liu5Tongyu Yang6Yan Zhang7Department of Neurosurgery, Peking University International HospitalChina National Clinical Research Center for Neurological DiseasesChina National Clinical Research Center for Neurological DiseasesChina National Clinical Research Center for Neurological DiseasesChina National Clinical Research Center for Neurological DiseasesChina National Clinical Research Center for Neurological DiseasesChina National Clinical Research Center for Neurological DiseasesChina National Clinical Research Center for Neurological DiseasesAbstract Background The increased permeability of the blood–brain barrier (BBB) is related to the occurrence and development of diseases such as acute ischemic stroke, chronic ischemia, or small vessel disease. Patients with carotid artery stenosis have chronic ischemia. The exact effect of carotid endarterectomy on the blood–brain barrier is still unclear. The aim of the study was to assess the effect of carotid endarterectomy on basic perfusion parameters and permeability surface area-product (PS). Methods The study included a total of 17 subjects (13 men), of which bilateral carotid artery stenosis was greater than 70%. All patients underwent unilateral carotid endarterectomy. Differences in the following computed tomography perfusion (CTP) parameters were compared before and after operation: cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP), and PS. PS acquired by CTP is used to measure the permeability of the BBB to contrast material. Results Before surgery, the operative side exhibited significantly lower CBF (p = 0.001) and prolonged MTT (p = 0.002) and TTP (p = 0.001) compared to the nonoperative side, while PS and CBV showed no significant differences. After carotid endarterectomy, only the operative side demonstrated improvements, with CBV increasing by 9.4%, MTT decreasing by 20.3%, TTP decreasing by 14.1%, and PS decreasing by 27.5% (all p < 0.01). No significant changes were observed on the nonoperative side. Conclusions Carotid endarterectomy augmented BBB permeability can be controlled by carotid endarterectomy in patients with carotid artery stenosis.https://doi.org/10.1186/s41016-025-00398-3Computed tomography perfusionCarotid endarterectomyCarotid artery stenosisBlood–brain barrierPermeability surface
spellingShingle Changyu Lu
Chenyu Zhu
Wenjie Li
Huan Zhu
Qihang Zhang
Tong Liu
Tongyu Yang
Yan Zhang
Carotid endarterectomy and blood-brain barrier permeability in subjects with bilateral carotid artery stenosis
Chinese Neurosurgical Journal
Computed tomography perfusion
Carotid endarterectomy
Carotid artery stenosis
Blood–brain barrier
Permeability surface
title Carotid endarterectomy and blood-brain barrier permeability in subjects with bilateral carotid artery stenosis
title_full Carotid endarterectomy and blood-brain barrier permeability in subjects with bilateral carotid artery stenosis
title_fullStr Carotid endarterectomy and blood-brain barrier permeability in subjects with bilateral carotid artery stenosis
title_full_unstemmed Carotid endarterectomy and blood-brain barrier permeability in subjects with bilateral carotid artery stenosis
title_short Carotid endarterectomy and blood-brain barrier permeability in subjects with bilateral carotid artery stenosis
title_sort carotid endarterectomy and blood brain barrier permeability in subjects with bilateral carotid artery stenosis
topic Computed tomography perfusion
Carotid endarterectomy
Carotid artery stenosis
Blood–brain barrier
Permeability surface
url https://doi.org/10.1186/s41016-025-00398-3
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