Ischemic complications following surgical treatment of moyamoya disease: risk factors and prevention

Лукшин, В А; Shulgina, A A; Usachev, D Yu; Korshunov, A E; Белоусова, О Б; Lubnin, А. Yu.

doi:10.17116/neiro20218506126

Cited by 5 publications

(2 citation statements)

References 23 publications

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“…Our study adopted STA-MCA bypass grafting surgery combined with temporal muscle patch for adults with moyamoya disease. Moyamoya disease in most patients is ischemic, so the surgical treatment is primarily to effectively improve the local blood supply of the brain in a short time and maximize the use of external carotid artery blood supply meantime 27. In our study, GCS scores of both the experimental group and control group increased notably after surgery compared with those before surgery, without notable difference between the 2 groups.…”

Section: Discussionmentioning

confidence: 48%

Clinical Efficacy of Superficial Temporal Artery-middle Cerebral Artery Bypass Grafting Surgery Combined With Temporal Muscle Patch on Patients With Moyamoya Disease

Gao

Chen

et al. 2022

Journal of Craniofacial Surgery

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Objective: To analyze the clinical efficacy of superficial temporal artery-middle cerebral artery (STA-MCA) bypass grafting surgery combined with temporal muscle patch and STA-MCA bypass grafting surgery alone on patients with moyamoya disease. Methods: Totally 73 patients confirmed with moyamoya disease in our hospital between January 2019 and December 2021 were enrolled. Among them, 43 patients treated with STA-MCA bypass grafting surgery combined with temporal muscle patch were assigned to the experiment group, whereas 30 patients treated with STA-MCA bypass grafting surgery alone to the control group. The following items of the 2 groups were compared: clinical efficacy, total effective rate, and disease control rate 6 months after surgery, the changes of modified Rankin Scale (mRS) and Karnofsky performance scale (KPS) scores before and on the seventh day and 6 months after surgery, and changes of Glasgow coma scale scores before and 24 hours after surgery. In addition, the incidences of cerebral ischemia and cerebral hemorrhage within 1 year after surgery were counted. The cerebral perfusion-associated indexes including relative mean transit time (rMTT), relative time-to-peak, relative cerebral blood flow (rCBF), and relative cerebral blood volume (rCBV) on the seventh day and 6 months after surgery were compared between the 2 groups, and the predictive value of cerebral perfusion-associated indexes before surgery for clinical efficacy on patients was analyzed. Results: The Glasgow coma scale score after surgery (P > 0.05) was similar between the 2 groups, but the clinical efficacy and total effective rate of the 2 groups were notably different (both P < 0.05). Compared with those before surgery, mRS scores of both groups declined, whereas KPS scores increased (both P < 0.05) on the seventh day after surgery. In addition, compared with those before surgery and on the seventh day after surgery, mRS scores of both groups decreased 6 months after surgery, whereas KPS scores increased (both P < 0.05). Both the groups showed decreased rMTT and rTPP, and increased rCBF and rCBV on the seventh day after surgery than those before surgery (all P < 0.05). In addition, both the groups still showed decreased rMTT and rTPP, and increased rCBF and rCBV 6 months after surgery than those before surgery and on the seventh day after surgery (all P < 0.05). Most notably, the experimental group displayed improved cerebral perfusionassociated indexes than the control group 6 months after surgery (all P < 0.05). The relief group showed notably higher rCBF and rCBV levels than the nonrelief group (both P < 0.05). According to ROC analysis, the areas under the curves of rCBF and rCBV in forecasting the clinical efficacy on patients were 0.842 and 0.823, respectively. Conclusion: Superficial temporal artery-middle cerebral artery bypass grafting surgery combined with temporal muscle patch can deliver a higher total clinical curative rate for patients with moyamoya disease and can alleviate their coma.

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Section: Discussionmentioning

confidence: 48%

Clinical Efficacy of Superficial Temporal Artery-middle Cerebral Artery Bypass Grafting Surgery Combined With Temporal Muscle Patch on Patients With Moyamoya Disease

Gao

Chen

et al. 2022

Journal of Craniofacial Surgery

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“…It is mainly caused by blood circulation disorder caused by intracranial vascular disease in patients, and the body's blood supply reduces as the disease progresses [17][18] . In patients with a history of hypertension, blood vessels are often blocked to varying degrees, which can reduce the regulatory function of cerebral blood vessels [19][20] . Patients with mRs scores of 3 to 5 points have decreased internal regulatory function, are prone to abnormal perfusion, and have an increased risk of complications [21][22] .…”

Section: Discussionmentioning

confidence: 99%

Analysis of Factors of Complications in Patients with Moyamoya Disease After Revascularization

2023

CNR

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Objective: In this study, the driving factors of complications in patients with moyamoya disease after revascularization are analyzed and discussed. Methods: A total of 1500 cases with moyamoya disease after revascularization in Yunan Shuifu People’s Hosptial and Beijing University of Chinese Medicine Third Affiliated Hospital from November 2017 to November 2022 were selected retrospectively, and they were divided into an observation group (with postoperative complications) and a control group (with no complications), resulting in 313 cases and 1187 cases in each group, respectively. Univariate and multivariate analysis were performed to screen out independent risk factors for complications in patients with moyamoya disease after revascularization. Results: Univariate analysis showed that the proportion of patients with cerebral ischemia, history of hypertension, and modified Rankin scale (mRs) score of 3-5 in the observation group were significantly higher than those in the control group. Complications were used as the dependent variable, and the indicators with statistically significant differences based on the univariate analysis were included as independent variables in the logistic regression analysis. The results showed that the first symptoms before operation were cerebral ischemia, history of hypertension, and mRs score of 3 to 5 were risk factors for complications in patients with moyamoya disease after revascularization, and there were significant differences in the data (OR = 1.781, 1.811, 1.859, all P < 0.05). Conclusion: Cerebral ischemia is the first symptom before operation, and history of hypertension and mRs score of 3 to 5 are all risk factors for complications in patients with moyamoya disease after revascularization. Therefore, clinical prevention should be strengthened, and corresponding treatment measures should be given in time to reduce the risk of postoperative complications in patients with moyamoya disease.

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Moyamoya Disease: Diagnosis, Management, and Roles of the Nurse Practitioners

Lianna¹,

Tailakh²,

Sotelo³

2023

The Journal for Nurse Practitioners

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Ischemic complications following surgical treatment of moyamoya disease: risk factors and prevention

Cited by 5 publications

References 23 publications

Clinical Efficacy of Superficial Temporal Artery-middle Cerebral Artery Bypass Grafting Surgery Combined With Temporal Muscle Patch on Patients With Moyamoya Disease

Clinical Efficacy of Superficial Temporal Artery-middle Cerebral Artery Bypass Grafting Surgery Combined With Temporal Muscle Patch on Patients With Moyamoya Disease

Analysis of Factors of Complications in Patients with Moyamoya Disease After Revascularization

Moyamoya Disease: Diagnosis, Management, and Roles of the Nurse Practitioners

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