Abstract：
BACKGROUND: Blood brain barrier disruption (BBBD) can be visualized by contrast extravasation (CE) after endovascular treatment (EVT) in patients with acute ischemic stroke. Elevated blood pressure is a risk factor for BBBD. However, the association between procedural blood pressure and CE post-EVT is unknown.
METHODS: In this single-center retrospective study, we analyzed 501 eligible patients who received a dual energy CT (DECT) immediately post-EVT for acute ischemic stroke. Procedural blood pressure values (SBPmean, SBPmax, SBPmax-min, and MAPmean) were collected. CE was quantified by measuring the maximum parenchymal iodine concentration on DECT iodine overlay map reconstructions. As a measure for the extent of BBBD, we created CE-ASPECTS by deducting one point per hyperdense ASPECTS region on iodine overlay maps. The association between blood pressure and CE was assessed using multivariable linear regression.
RESULTS: The procedural SBPmean, SBPmax, and MAPmean were 150 ± 26 mmHg, 173 ± 29 mmHg, and 101 ± 17 mmHg, respectively. The median maximum iodine concentration on post-EVT DECT was 1.2 mg/ml (IQR 0.7-2.0), and median CE-ASPECTS was 8 (IQR 5-11). The maximum iodine concentration was not associated with blood pressure. SBPmean, SBPmax, and MAPmean were significantly associated with CE-ASPECTS (per 10 mmHg, β = -0.2, 95 % CI -0.31 to -0.09, β = -0.15, 95 % CI -0.25 to -0.06, β = -0.33, 95 % CI -0.49 to -0.17, respectively).
CONCLUSIONS: In acute ischemic stroke patients undergoing EVT, particularly in patients achieving successful recanalization, SBPmean, SBPmax, and MAPmean are associated with the extent of BBBD on immediate post-EVT DECT, but not with maximum iodine concentration.
METHODS: In this single-center retrospective study, we analyzed 501 eligible patients who received a dual energy CT (DECT) immediately post-EVT for acute ischemic stroke. Procedural blood pressure values (SBPmean, SBPmax, SBPmax-min, and MAPmean) were collected. CE was quantified by measuring the maximum parenchymal iodine concentration on DECT iodine overlay map reconstructions. As a measure for the extent of BBBD, we created CE-ASPECTS by deducting one point per hyperdense ASPECTS region on iodine overlay maps. The association between blood pressure and CE was assessed using multivariable linear regression.
RESULTS: The procedural SBPmean, SBPmax, and MAPmean were 150 ± 26 mmHg, 173 ± 29 mmHg, and 101 ± 17 mmHg, respectively. The median maximum iodine concentration on post-EVT DECT was 1.2 mg/ml (IQR 0.7-2.0), and median CE-ASPECTS was 8 (IQR 5-11). The maximum iodine concentration was not associated with blood pressure. SBPmean, SBPmax, and MAPmean were significantly associated with CE-ASPECTS (per 10 mmHg, β = -0.2, 95 % CI -0.31 to -0.09, β = -0.15, 95 % CI -0.25 to -0.06, β = -0.33, 95 % CI -0.49 to -0.17, respectively).
CONCLUSIONS: In acute ischemic stroke patients undergoing EVT, particularly in patients achieving successful recanalization, SBPmean, SBPmax, and MAPmean are associated with the extent of BBBD on immediate post-EVT DECT, but not with maximum iodine concentration.
摘要：
背景：急性缺血性卒中患者血管内治疗（EVT）后造影剂外渗（CE）可观察血脑屏障破坏（BBBD）。血压升高是BBBD的危险因素。然而,手术血压和CE术后EVT之间的关联尚不清楚.
方法：在这项单中心回顾性研究中，我们分析了因急性缺血性卒中而在EVT后立即接受双能量CT(DECT)的501例符合条件的患者.程序血压值（SBP均值，SBPmax,SBPmax-min,和MAPmean)被收集。通过测量DECT碘覆盖图重建上的最大实质碘浓度来量化CE。作为衡量BBBD程度的指标，我们通过在碘覆盖图上每个高密度ASPECTS区域扣除一个点来创建CE-ASPECTS。使用多变量线性回归评估血压与CE之间的关联。
结果：程序SBPmean，SBPmax,MAPmean为150±26mmHg，173±29mmHg，和101±17mmHg，分别。EVT后DECT的最大碘浓度中位数为1.2mg/ml（IQR0.7-2.0），中位CE-ASPECTS为8（IQR5-11）。最大碘浓度与血压无关。SBPmean,SBPmax,和MAPmean与CE-ASPERTS显着相关（每10mmHg，β=-0.2，95%CI-0.31至-0.09，β=-0.15，95%CI-0.25至-0.06，β=-0.33，95%CI-0.49至-0.17）。
结论：在接受EVT的急性缺血性卒中患者中，特别是在那些获得成功再通的人中，SBPmean,SBPmax,MAPmean与EVTDECT后即刻BBBD的程度相关，但不是最大碘浓度。
方法：在这项单中心回顾性研究中，我们分析了因急性缺血性卒中而在EVT后立即接受双能量CT(DECT)的501例符合条件的患者.程序血压值（SBP均值，SBPmax,SBPmax-min,和MAPmean)被收集。通过测量DECT碘覆盖图重建上的最大实质碘浓度来量化CE。作为衡量BBBD程度的指标，我们通过在碘覆盖图上每个高密度ASPECTS区域扣除一个点来创建CE-ASPECTS。使用多变量线性回归评估血压与CE之间的关联。
结果：程序SBPmean，SBPmax,MAPmean为150±26mmHg，173±29mmHg，和101±17mmHg，分别。EVT后DECT的最大碘浓度中位数为1.2mg/ml（IQR0.7-2.0），中位CE-ASPECTS为8（IQR5-11）。最大碘浓度与血压无关。SBPmean,SBPmax,和MAPmean与CE-ASPERTS显着相关（每10mmHg，β=-0.2，95%CI-0.31至-0.09，β=-0.15，95%CI-0.25至-0.06，β=-0.33，95%CI-0.49至-0.17）。
结论：在接受EVT的急性缺血性卒中患者中，特别是在那些获得成功再通的人中，SBPmean,SBPmax,MAPmean与EVTDECT后即刻BBBD的程度相关，但不是最大碘浓度。
