{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:14:32Z","timestamp":1790421272036,"version":"4.1.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Multimodal imaging has expanded treatment for patients with acute ischemic stroke with large vessel occlusion. Blood-brain barrier (BBB) disruption measured in the ischemic core is associated with hemorrhagic transformation. However, the associations between core BBB disruption (cBBBD) and baseline clinical\/imaging variables, as well as 3-month outcome, have not been explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>This is a retrospective multicenter analysis of consecutive anterior circulation patients with acute ischemic stroke with large vessel occlusion, presenting over a 4-year time period, who were transferred from a primary to a comprehensive stroke center for possible endovascular therapy, with magnetic resonance imaging that included perfusion-weighted imaging before transfer. Magnetic resonance imaging scans were processed using RAPID software to generate penumbral imaging variables. Perfusion-weighted images were processed to detect and quantify contrast leakage; cBBBD was calculated as the average of all leaky voxels in the ischemic core. Poor functional outcome was defined as a modified Rankin Scale score of &gt;2 at 3 months. Linear regression was used except for the outcome, which used logistic regression, controlling for age, stroke severity, and baseline functional status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Out of 411 patients transferred for endovascular therapy, 291 were included in this analysis with a median age of 74 years; 49% were female patients. The median National Institutes of Health Stroke Scale score was 13, the mean core volume was 32.3 mL, and the mean cBBBD was 2.1%. 71% of patients underwent endovascular therapy. Admission National Institutes of Health Stroke Scale score (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001) and glucose level (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.033) were independently correlated with cBBBD. All imaging variables correlated strongly with cBBBD (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). The strongest correlation was 0.50, observed between cBBBD and mismatch ratio (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      =0.254). Increasing cBBBD was independently associated with poor functional outcome (adjusted odds ratio, 1.16 [CI, 1.03\u20131.32];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.019; n=279), indicating that for every 1% increase in cBBBD, the odds of having a poor functional outcome increase by 16%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In acute ischemic stroke with large vessel occlusion, disruption of the BBB in the core lesion is independently associated with clinical outcome. cBBBD represents a new imaging profile for acute stroke that may help guide treatments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.126.055955","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T09:00:32Z","timestamp":1778058032000},"page":"1727-1736","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Core Blood-Brain Barrier Disruption in Patients With Large Vessel Occlusion"],"prefix":"10.1161","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8285-1815","authenticated-orcid":true,"given":"Richard","family":"Leigh","sequence":"first","affiliation":[{"name":"Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nefeli","family":"Valyraki","sequence":"additional","affiliation":[{"name":"Department of Neurology (N.V., P.S.), H\u00f4pital Fondation A. de Rothschild, Paris, France."},{"name":"Universit\u00e9 Paris Cit\u00e9, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team Turc, France (N.V., A.t.S., C.A., P.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6513-9730","authenticated-orcid":true,"given":"Nae-Yuh","family":"Wang","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Biostatistics, and Epidemiology, Johns Hopkins University, Baltimore, MD (N.-Y.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5578-9304","authenticated-orcid":true,"given":"Manar","family":"Abomulay","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital of Toulouse, France (M.A., J.M.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7354-3351","authenticated-orcid":true,"given":"Adrien","family":"ter Schiphorst","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team Turc, France (N.V., A.t.S., C.A., P.S.)."},{"name":"Department of Neurology (A.t.S., C.A.), CHRU Gui de Chauliac, Montpellier, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adri\u00e1n","family":"Valls Carb\u00f3","sequence":"additional","affiliation":[{"name":"Department of Neurosciencies, Germans Trias I Pujol University Hospital, Badalona, Spain (A.V.C., M.H.-P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8279-7954","authenticated-orcid":true,"given":"Mar\u00eda","family":"Hern\u00e1ndez-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Neurosciencies, Germans Trias I Pujol University Hospital, Badalona, Spain (A.V.C., M.H.-P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3696-0834","authenticated-orcid":true,"given":"Fr\u00e9d\u00e9rique","family":"Charbonneau","sequence":"additional","affiliation":[{"name":"Department of Radiology (F.C.), H\u00f4pital Fondation A. de Rothschild, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7347-1039","authenticated-orcid":true,"given":"Caroline","family":"Arquizan","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team Turc, France (N.V., A.t.S., C.A., P.S.)."},{"name":"Department of Neurology (A.t.S., C.A.), CHRU Gui de Chauliac, Montpellier, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3976-3772","authenticated-orcid":true,"given":"Anne","family":"Wacongne","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nimes University Hospital, France (A.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9038-7119","authenticated-orcid":true,"given":"Denis","family":"Sablot","sequence":"additional","affiliation":[{"name":"Department of Neurology, Perpignan Hospital, France (D.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Costalat","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology (V.C.), CHRU Gui de Chauliac, Montpellier, 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