Evidence mapPaperPMID 42385121Full record

ArticleNeurology2026

Blood-Brain Barrier Disruption Before Interhospital Transfer for Thrombectomy and Clinical Outcome.

Nefeli Eirini Valyraki, Richard Leigh, Adrien Ter Schiphorst, Adrián Valls-Carbó, Frédérique Charbonneau, Caroline Arquizan, Denis Sablot, Anne Wacongne, Vincent Costalat, Canan Ozsancak and 9 more

Abstract readMulticenter Study
In one paragraph

Article in Neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Nefeli Eirini ValyrakiNeurology Department, Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0002-5572-2583
Richard LeighDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD.ORCID 0000-0002-8285-1815
Adrien Ter SchiphorstUniversité Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team Turc, Paris, France.ORCID 0000-0002-7354-3351
Adrián Valls-CarbóStroke Unit, Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Spain.ORCID 0000-0002-4831-1276
Frédérique CharbonneauImaging Department, Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0002-3696-0834
Caroline ArquizanUniversité Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team Turc, Paris, France.ORCID 0000-0001-7347-1039
Denis SablotNeurology Department, CH Perpignan, France.ORCID 0000-0002-9038-7119
Anne WacongneNeurology Department, CHU Nimes, France.ORCID 0000-0002-3976-3772
Vincent CostalatNeuroradiology Department, CHRU Gui de Chauliac, Montpellier, France.ORCID 0000-0001-8428-9101
Canan OzsancakCRFA Le COTEAU-UGECAM, 45380 La Chapelle-Saint Mesmin, France.
Clara CohenUniversity Hospital Center of Orléans, Neuroradiology Department, France.ORCID 0000-0002-8200-2784
Marco PasiNeurology Department, CIC-IT 1415, INSERM 1253 iBrain, Centre Hospitalier Universitaire de Tours, Université de Tours, France.ORCID 0000-0001-9976-2459
Gregoire BoulouisDiagnostic and Interventional Neuroradiology Department, Centres d'Investigation Clinique - Innovation Technologique (CIC-IT) 1415, INSERM 1253 iBrain, Centre Hospitalier Universitaire de Tours, Université de Tours, France.ORCID 0000-0001-8422-9205
Manar AbomulayAcute Stroke Unit, Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, University of Toulouse, INSERM, France; and.
Maria Hernandez-PerezStroke Unit, Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Spain.ORCID 0000-0001-8279-7954
Nicole YuenStanford Stroke Center, CA.ORCID 0000-0003-3206-6656
Gregory W AlbersStanford Stroke Center, CA.ORCID 0000-0003-0263-4632
Jean Marc OlivotAcute Stroke Unit, Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, University of Toulouse, INSERM, France; and.ORCID 0000-0003-2027-2276
Pierre SenersNeurology Department, Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0002-2134-0691

Funding

Global Blood-Brain Barrier Disruption and Post-Stroke Cognitive DeclineR01NS123386 · JOHNS HOPKINS UNIVERSITY · 2025 to 2025
$599k
NINDS NIH HHS R01 NS123386
6 · The paper itself

Abstract

BACKGROUND AND

objectivesIn acute ischemic stroke with large vessel occlusion (AIS-LVO), interhospital transfer for endovascular therapy (EVT) provides an ideal therapeutic window during which neuroprotective strategies could be evaluated, allowing sufficient exposure before reperfusion. We aimed to determine whether blood-brain barrier (BBB) disruption assessed before interhospital transfer for EVT is associated with 24-hour hemorrhagic transformation (HT) and 3-month functional outcome.

methodsIn this multicenter retrospective study, we included patients with anterior circulation AIS-LVO transferred from 4 French primary stroke centers (PSCs) to comprehensive stroke centers for EVT assessment, with baseline MR perfusion imaging performed at the PSC before transfer. BBB disruption was quantified as the percentage signal change due to gadolinium leakage on perfusion source images. Mean permeability derangement (MPD) was defined as the average of all voxels within the ischemic core exhibiting permeability values greater than a prespecified threshold. The primary outcome was any intraparenchymal HT on 24-hour follow-up imaging. The association between MPD and HT was studied in multivariable mixed binary logistic regression analyses.

resultsA total of 289 patients were included: the median age was 74 years (interquartile range 63-81), 49% were female, the median NIHSS score was 13 (7-19), the median last-seen-well-to-PSC imaging time was 2.5 hours (1.7-4.7), and the median core volume was 17 mL (0-40). Intravenous thrombolysis was administered before transfer in 71% of patients, and EVT was eventually performed in 71%. The median time from PSC imaging to comprehensive stroke center arrival was 3.3 hours (2.6-3.8). Any HT at 24 hours occurred in 129 patients (45%). In multivariable analysis, MPD ≥3% was independently associated with any HT (OR 6.58; 95% CI 2.84-15.22; DISCUSSION: BBB disruption on pretransfer perfusion MRI is associated with 24-hour HT and poor 3-month functional outcome in patients with AIS-LVO. These findings highlight its potential value for early risk stratification and justify prospective evaluation of BBB-targeted strategies during interhospital transfer for EVT.

Indexed as

Blood-Brain BarrierIschemic StrokePatient TransferThrombectomyAgedAged, 80 and overEndovascular ProceduresFemaleHumansMaleMiddle AgedPerfusion Magnetic Resonance ImagingRetrospective StudiesTreatment Outcome

Identifiers

PMID42385121
PMCPMC13382865

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.