Surgical Revascularization in North American Adults with Moyamoya Phenomenon: Long-Term Angiographic Follow-up.
Surgical Revascularization in North American Adults with Moyamoya Phenomenon: Long-Term Angiographic Follow-up.
复制标题
DOI：
10.1016/j.jstrokecerebrovasdis.2015.03.053
复制
发表时间：
2015-07
影响因子：
2.5
通讯作者：
Zipfel, Gregory J.
中科院分区：
文献类型：
--
作者：
Arias, Eric J.;Dunn, Gavin P.;Washington, Chad W.;Derdeyn, Colin P.;Chicoine, Michael R.;Grubb, Robert L., Jr.;Moran, Christopher J.;Cross, DeWitte T., III;Dacey, Ralph G., Jr.;Zipfel, Gregory J.
North American and Asian forms of moyamoya have distinct clinical characteristics. Asian adults with moyamoya are known to respond better to direct vs. indirect revascularization. It is unclear whether North American adults with moyamoya have a similar long-term angiographic response to direct vs. indirect bypass. A retrospective review of surgical revascularization for adult moyamoya phenomenon was performed. Pre-operative and post-operative cerebral angiograms underwent consensus review, with degree of revascularization quantified as extent of new middle cerebral artery (MCA) territory filling. Late angiographic follow up was available in 15 symptomatic patients who underwent 20 surgical revascularization procedures. In 10 hemispheres treated solely with indirect arterial bypass, 3 had 2/3 revascularization, 4 had 1/3 revascularization, and 3 had no revascularization of the MCA territory. In the 10 hemispheres treated with direct arterial bypass (8 as a stand alone procedure; 2 in combination with an indirect procedure), 2 had complete revascularization, 7 had 2/3 revascularization, and 1 had 1/3 revascularization. Direct bypass provided a higher rate of “good” angiographic outcome (complete or 2/3 revascularization) when compared to indirect techniques (p = 0.0198). Direct bypass provides a statistically significant, more consistent and complete cerebral revascularization than indirect techniques in this patient population. This is similar to that reported in the Asian literature, which suggests that the manner of presentation (ischemia in North American adults vs. hemorrhage in Asian adults) is likely not a contributor to the extent of revascularization achieved following surgical intervention.
登录
查看更多内容
影响因子：
4.8
作者：
Amin-Hanjani, Sepideh;Singh, Amritha;Charbel, Fady T.
通讯作者：
Charbel, Fady T.
影响因子：
0.7
作者：
Isono, M;Ishii, K;Kobayashi, H
通讯作者：
Kobayashi, H
影响因子：
4.8
作者：
KINUGASA, K;MANDAI, S;KOBAYASHI, S
通讯作者：
KOBAYASHI, S
影响因子：
4.1
作者：
Kawaguchi, S;Okuno, S;Sakaki, T
通讯作者：
Sakaki, T
影响因子：
2.4
作者：
Houkin, K;Kuroda, S;Abe, H
通讯作者：
Abe, H