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Int. J. Mol. Sci. 2017, 18(5), 1008; doi:10.3390/ijms18051008

Carotid Artery Stenting and Blood–Brain Barrier Permeability in Subjects with Chronic Carotid Artery Stenosis

1
2nd Department of Radiology, Medical University of Gdansk, Gdansk 80-210, Poland
2
Department of Cardiovascular Surgery, Medical University of Gdansk, Gdansk 80-210, Poland
3
Department of Economic Sciences, Faculty of Management and Economics, Gdansk University of Technology, Gdansk 80-210, Poland
4
1st Department of Radiology, Medical University of Gdansk, Gdansk 80-210, Poland
5
Department of Diagnostic Imaging, Medical University of Warsaw, Warsaw 03-242, Poland
6
Department of Nuclear Medicine, Medical University of Gdansk, Gdansk 80-210, Poland
7
Institute of Human Physiology, Medical University of Gdansk, Gdansk 80-210, Poland
8
Department of Clinical Sciences, Institute of Health Sciences, Pomeranian University of Slupsk, Slupsk 76-200, Poland
*
Author to whom correspondence should be addressed.
Academic Editor: Kuniaki Ogasawara
Received: 13 March 2017 / Revised: 23 April 2017 / Accepted: 3 May 2017 / Published: 8 May 2017
(This article belongs to the Special Issue Cerebral Blood Flow and Metabolism)
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Abstract

Failure of the blood-brain barrier (BBB) is a critical event in the development and progression of diseases such as acute ischemic stroke, chronic ischemia or small vessels disease that affect the central nervous system. It is not known whether BBB breakdown in subjects with chronic carotid artery stenosis can be restrained with postoperative recovery of cerebral perfusion. The aim of the study was to assess the short-term effect of internal carotid artery stenting on basic perfusion parameters and permeability surface area-product (PS) in such a population. Forty subjects (23 males) with stenosis of >70% within a single internal carotid artery and neurological symptoms who underwent a carotid artery stenting procedure were investigated. Differences in the following computed tomography perfusion (CTP) parameters were compared before and after surgery: global 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. In all baseline cases, the CBF and CBV values were low, while MTT and TTP were high on both the ipsi- and contralateral sides compared to reference values. PS was approximately twice the normal value. CBF was higher (+6.14%), while MTT was lower (−9.34%) on the contralateral than on the ipsilateral side. All perfusion parameters improved after stenting on both the ipsilateral (CBF +22.66%; CBV +18.98%; MTT −16.09%, TTP −7.62%) and contralateral (CBF +22.27%, CBV +19.72%, MTT −14.65%, TTP −7.46%) sides. PS decreased by almost half: ipsilateral −48.11%, contralateral −45.19%. The decline in BBB permeability was symmetrical on the ipsi- and contralateral sides to the stenosis. Augmented BBB permeability can be controlled by surgical intervention in humans. View Full-Text
Keywords: computed tomography perfusion; carotid artery stenosis; blood–brain barrier; permeability surface; cerebral blood flow; cerebral blood volume; mean transit time; time to peak computed tomography perfusion; carotid artery stenosis; blood–brain barrier; permeability surface; cerebral blood flow; cerebral blood volume; mean transit time; time to peak
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Szarmach, A.; Halena, G.; Kaszubowski, M.; Piskunowicz, M.; Studniarek, M.; Lass, P.; Szurowska, E.; Winklewski, P.J. Carotid Artery Stenting and Blood–Brain Barrier Permeability in Subjects with Chronic Carotid Artery Stenosis. Int. J. Mol. Sci. 2017, 18, 1008.

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