THE RISK FACTORS OF BLOOD-BRAIN BARRIER DISRUPTION AFTER ENDOVASCULAR TREATMENT IN PATIENTS WITH CEREBRAL INFARCTION AND ITS RELATIONSHIP WITH EARLY PROGNOSIS

Yan Wang^{1, #}, Chunqian Cai^{2, #}, Jinquan Hu^{3, *}

¹Neurotrauma rehabilitation, Characteristic Medical Center of Chinese People’s Armed Police Force, Tianjin, 300162, China - ²Acupuncture and Moxibustion Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China - ³Department of Neurology, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, China

Introduction: To explore the risk factors of blood-brain barrier disruption after endovascular treatment in patients with cerebral infarction and its relationship with early prognosis, so as to provide more reference for subsequent prognosis evaluation and the development of more targeted therapeutic schedule. 

Materials and methods: 334 patients with cerebral infarction undergoing endovascular treatment in our hospital from January 2018 to June 2022 were included in this study. They were divided into destruction group (202 cases) and intact group (132 cases) according to the presence or absence of blood-brain barrier disruption. Univariate and multivariate analyses were employed to evaluate the risk factors of blood-brain barrier disruption after endovascular treatment, and analyze the correlation between blood-brain barrier disruption and poor early prognosis. 

Results: There were statistically significant differences between two groups in concurrent diabetes, randomized blood glucose level, baseline NIHSS score, concurrent cardiogenic embolism, concurrent internal carotid/middle cerebral artery occlusion, poor rate of early prognosis and 90-day follow-up mortality (P<0.05). The results of univariate and multivariate analyses of logistic regression model indicated that baseline NIHSS score, concurrent cardiogenic embolism and middle cerebral artery occlusion were independent influence factors of blood-brain barrier disruption after endovascular treatment (P<0.05). The incidence of blood-brain barrier disruption in poor prognosis subgroup was significantly higher than that in good prognosis subgroup (P<0.05). Multivariate analysis of logistic regression model showed that the occurrence of blood-brain barrier disruption was independently related to poor early prognosis after endovascular treatment (P<0.05). 

Conclusion: The occurrence of blood-brain barrier disruption after endovascular treatment in patients with cerebral infarction is independently related to baseline NIHSS score, concurrent cardiogenic embolism and middle cerebral artery occlusion. At the same time, patients with blood-brain barrier disruption are at a higher risk of poor early prognosis, so more active treatment should be given clinically to maximize the improvement of clinical outcome.