The Efficacy of Single Barrel Superficial Temporal Artery-middle Cerebral Artery Bypass in Treatment of Adult Patients with Ischemic-type Moyamoya Disease

Ha, Mahnjeong; Choi, Chang Hwa; Lee, Jae Il; Heon, Seung; Lee, Sang Weon; Ko, Jun Kyeung

doi:10.7461/jcen.2016.18.3.239

Cited by 11 publications

(8 citation statements)

References 22 publications

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“…NDS score in control group was not significantly changed at 6 and 12 months after treatment compared with pretreatment values, while NDS score in observation group was significantly reduced at 6 and 12 months after treatment compared with pretreatment values. The data show that interventional treatment of blood vessels can improve neurological function in patients, which is consistent with the findings reported by Ha et al ( 21 ). Vascular intervention can expand stenosed blood vessels, thereby restoring brain tissue blood supply, promoting the repair of damaged brain regeneration and improving patient's neurological function.…”

Section: Discussionsupporting

confidence: 92%

Therapeutic effect of vascular interventional therapy and aspirin combined with defibrase on cerebral ischemia in rats

Geng

Dai

2018

Exp Ther Med

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Therapeutic effect of vascular interventional therapy and aspirin combined with defibrase in the treatment of cerebral ischemia in rat model were investigated. Ninety rats were selected to establish cerebral ischemia model. Animal models were randomly divided into observation group and control group, with 45 rats in each group. Rats in observation group were treated with vascular intervention, and control group was treated with aspirin combined with defibrase. Peak systolic velocity (Vs) and end-diastolic velocity (Vd) were compared between two groups before and after 12 months of treatment. Therapeutic effects were compared before and after 6 months, and before and after 12 months of treatment. Vs and Vd of vascular lesions in observation group at 12 months were reduced after treatment, and were significantly lower than those in control group (p<0.05). After treatment, Vs and Vd in observation group were significantly reduced (p<0.05). There was no significant difference in Vs and Vd values between the groups before treatment (p>0.05). NDS scores in observation group were significantly lower than those in control group at 6 months and 1 year after treatment (p<0.05). There were no significant changes in NDS score at 6 and 12 months after treatment in control group compared with pretreatment group (p>0.05). NDS in observation group was significantly reduced at 6 and 12 months after treatment compared with pretreatment level (p<0.05). One year after treatment, incidence of cerebral infarction and transient ischemic attack and mortality in observation group were significantly lower than those in the control group (p<0.05). Intracranial vascular interventional therapy can achieve satisfactory outcomes in the treatment of cerebral ischemia, and can effectively promote nerve function recovery, and reduce the incidence of cerebrovascular diseases and mortality.

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Section: Discussionsupporting

confidence: 92%

Therapeutic effect of vascular interventional therapy and aspirin combined with defibrase on cerebral ischemia in rats

Geng

Dai

2018

Exp Ther Med

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“…The Caucasian Krupp Hospital cohort showed that, with the use of duplex ultrasound, the patency of the STA–MCA bypass at 3 months was 100% (22). In addition, Ha et al showed that the postoperative patency of single barrel STA-MCA was 88.4% on follow-up imaging (mean, 16.5 months) (23). In our study, the patency of the bypasses was 88.3% on follow-up DSA (median, 18 months), which was similar with the study of Ha et al…”

Section: Discussionmentioning

confidence: 99%

Angiographic Outcomes of Direct and Combined Bypass Surgery in Moyamoya Disease

Liu

et al. 2019

Front. Neurol.

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Objective: To identify associated risk factors for the angiographic outcomes after direct and combined bypass surgery in moyamoya disease (MMD).Methods: All direct and combined bypass procedures performed from June 2009 to May 2015 were screened in this prospective cohort study. Patients who acquired presurgical and follow-up catheter angiography were included. Bypass patency and postoperative collateral formation were evaluated. Univariate and multivariate logistic regression analyses were performed to determine the influence factors for bypass patency and postoperative collateral formation.Results: In total, 188 consecutive bypass procedures were included. After an 18-month median follow-up, the anastomosis patency rate was 88.3%. Postoperative collateral formation was associated with the patency of the anastomosis (Gamma = 0.891, p < 0.001). Multivariate logistic regression analysis showed that presence of hemorrhage (OR, 0.298; 95% CI, 0.125–0.709; p = 0.006) was associated with obstructed anastomosis. Among the 188 bypass surgeries, 125 (63.2%) hemispheres had good postoperative collateral formation and 85 (36.8%) had poor postoperative collateral formation. Multivariate logistic regression analysis showed that younger age at operation (OR, 2.396; 95% CI, 1.231–4.664; p = 0.010) was associated with good postoperative collateral formation, while the poor postoperative collateral formation was related to presence of hemorrhage (OR, 0.329; 95% CI, 0.143–0.758; p = 0.009) and dilated anterior choroidal artery (OR, 0.472; 95% CI, 0.240–0.929; p = 0.030).Conclusions: This study has demonstrated that presence of hemorrhage predicts lower patency rates. Younger age at operation was associated with good postoperative collateral formation, while the poor postoperative collateral formation was related to presence of hemorrhage and dilated anterior choroidal artery.

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“…The long-term graft patency rate after direct or combined revascularization for overall MMD was reported to be 88.3–100.0%, and hemorrhagic presentation was indicated to have an inverse effect on graft patency [ 12 , 13 , 18 , 21 , 23 , 26 , 27 , 28 ]. About 22.5–45.1% direct anastomosis was observed to be occluded during postoperative angiographic follow-up of 10–18 months [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

Delayed Anastomotic Occlusion after Direct Revascularization in Adult Hemorrhagic Moyamoya Disease

et al. 2021

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Delayed anastomotic occlusion occurred in a considerable proportion of hemorrhagic moyamoya disease (MMD) patients undergoing direct revascularization. This study aimed to investigate the predictors and outcomes of delayed anastomotic occlusion in adult hemorrhagic MMD. The authors retrospectively reviewed 87 adult hemorrhagic MMD patients. Univariate and multivariate logistic regression analyses were performed. After an average of 9.1 ± 6.9 months of angiographic follow-up, the long-term graft patency rates were 79.8%. The occluded group had significantly worse angiogenesis than the non-occluded group (p < 0.001). However, the improvement of dilated anterior choroidal artery–posterior communicating artery was similar (p = 0.090). After an average of 4.0 ± 2.5 years of clinical follow-up, the neurological statues and postoperative annualized rupture risk were similar between the occluded and non-occluded groups (p = 0.750; p = 0.679; respectively). In the multivariate logistic regression analysis, collateral circulation Grade III (OR, 4.772; 95% CI, 1.184–19.230; p = 0.028) and preoperative computed tomography perfusion (CTP) Grade I–II (OR, 4.129; 95% CI, 1.294–13.175; p = 0.017) were independent predictors of delayed anastomotic occlusion. Delayed anastomotic occlusion in adult hemorrhagic MMD might be a benign phenomenon. Good collateral circulation (Grade III) and compensable preoperative intracranial perfusion (CTP Grade I–II) are independent predictors for this phenomenon. Moreover, the delayed anastomotic occlusion has no significant correlations with the long-term angiographic and neurological outcomes, except neoangiogenesis.

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The Efficacy of Single Barrel Superficial Temporal Artery-middle Cerebral Artery Bypass in Treatment of Adult Patients with Ischemic-type Moyamoya Disease

Cited by 11 publications

References 22 publications

Therapeutic effect of vascular interventional therapy and aspirin combined with defibrase on cerebral ischemia in rats

Therapeutic effect of vascular interventional therapy and aspirin combined with defibrase on cerebral ischemia in rats

Angiographic Outcomes of Direct and Combined Bypass Surgery in Moyamoya Disease

Delayed Anastomotic Occlusion after Direct Revascularization in Adult Hemorrhagic Moyamoya Disease

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