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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BMC
2025-06-01
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| Series: | Chinese Neurosurgical Journal |
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| 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 |
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| 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. |
| format | Article |
| id | doaj-art-220106ee8a924046935cfa7799084ac3 |
| institution | OA Journals |
| issn | 2057-4967 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
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| series | Chinese Neurosurgical Journal |
| 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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