Department of Vascular Surgery and Angiology, Medical University of Lublin, 20-078 Lublin, Poland.
Department of Vascular Surgery, General and Transplant Surgery, Medical University in Wroclaw, 50-355 Wroclaw, Poland.
Int J Environ Res Public Health. 2022 May 20;19(10):6210. doi: 10.3390/ijerph19106210.
Endarterectomy and angioplasty of the internal carotid artery are surgical measures for the prevention of ischemic stroke. Perioperative complications are caused by concomitant embolism and reperfusion syndrome leading to damage of the blood-brain barrier.
The study included 88 patients divided into two groups, depending on the surgical technique used: internal carotid artery endarterectomy (CEA), 66 patients, and percutaneous carotid angioplasty and stenting (CAS), 22 patients. Blood was drawn 24 h before surgery, as well as 8, 24, and 48 h post-surgery. The assessment of damage to the blood-brain barrier was based on the evaluation of the concentration of claudin-1 and occludin, aquaporin-4, the measurements of the activity of metalloproteinase-2 (MMP-2) and -9 (MMP-9), and the assessment of central nervous system damage, measured by changes in the blood S100β protein concentration.
A significant increase in the concentration of the blood-brain barrier damage markers and increased MMP-2 and MMP-9 activity were found in patient blood. The degree of damage to the blood-brain barrier was higher in the CEA group.
The authors' own research has indicated that revascularization of the internal carotid artery may lead to damage to the central nervous system secondary to damage to the blood-brain barrier.
颈内动脉内膜切除术和血管成形术是预防缺血性中风的手术措施。围手术期并发症是由伴随的栓塞和再灌注综合征引起的，导致血脑屏障损伤。
本研究纳入了 88 名患者，根据所使用的手术技术分为两组：颈内动脉内膜切除术（CEA）组 66 例，经皮颈动脉血管成形术和支架置入术（CAS）组 22 例。分别在手术前 24 小时以及手术后 8、24 和 48 小时抽取血液。血脑屏障损伤的评估基于 Claudin-1 和 Occludin、水通道蛋白-4 浓度的评估、基质金属蛋白酶-2（MMP-2）和 -9（MMP-9）活性的测量，以及通过 S100β 蛋白浓度变化评估中枢神经系统损伤。
患者血液中发现血脑屏障损伤标志物浓度显著升高，MMP-2 和 MMP-9 活性增加。CEA 组血脑屏障损伤程度更高。
作者自己的研究表明，颈内动脉再通可能导致血脑屏障损伤引起的中枢神经系统损伤。
