Postoperative collateral formation after indirect bypass for hemorrhagic moyamoya disease
Postoperative collateral formation after indirect bypass for hemorrhagic moyamoya disease
复制标题
出血性烟雾病间接搭桥术后侧支循环形成
DOI：
10.1186/s12883-020-1612-z
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发表时间：
2020-01-17
期刊：
影响因子：
2.6
通讯作者：
Zhao, Jizong
中科院分区：
文献类型：
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作者：
Ge, Peicong;Zhang, Qian;Zhao, Jizong
背景数字减影血管造影（DSA）评价出血性烟雾病（MMD）术后侧支形成的研究有限。我们的研究目的是调查出血性MMD.Methods2010年1月至2018年12月在首都医科大学北京天坛医院接受间接转流术的所有连续出血性MMD住院患者的术后侧支形成情况。出血部位分为前部或后部。采用Matsushima量表在侧位片上评价术后侧支形成。进行单因素和多因素Logistic回归分析，以确定影响术后侧支形成的因素。在平均8.5个月的DSA随访后，14个（21.9%）半球侧支循环为A级，13个（20.3%）半球侧支循环为B级，37个（57.8%）半球侧支循环为C级。27个（42.2%）半球术后侧支形成良好，37个（57.8%）半球术后侧支形成较差。单因素Logistic回归分析显示，手术年龄（OR，0.954; 95% CI，0.908-1.003;p= 0.066），出血部位（OR，4.694; 95%CI，1.582-13.923;p= 0.005），PCA受累（OR，3.474; 95%CI，0.922-13.086;p= 0.066）可能影响术后侧支循环形成。多因素Logistic回归分析显示，只有前壁出血（OR5.222，95%CI1.605 -16.987，p= 0.006）与术后侧支循环形成良好显著相关。
BackgroundThe research on postoperative collateral formation for hemorrhagic moyamoya disease (MMD) evaluated by using digital subtraction angiography (DSA) is limited. Our study objective was to investigate the postoperative collateral formation after indirect bypass for hemorrhagic MMD.MethodsAll consecutive inpatients with hemorrhagic MMD who received indirect bypass at Beijing Tiantan Hospital, Capital Medical University from January 2010 through December 2018 were screened. The site of the hemorrhage was classified as either anterior or posterior. Postoperative collateral formation was evaluated on lateral views using the Matsushima scale. Univariate and multivariate logistic regression analyses were carried out to determine the factors influencing postoperative collateral formation.ResultsSix-four patients (64 hemispheres) were included in this study. After a median 8.5 months DSA follow-up, 14 (21.9%) hemispheres had grade A collateral circulation, 13 (20.3%) had grade B, and 37 (57.8%) had grade C. Twenty-seven (42.2%) hemispheres had good postoperative collateral formation and 37 (57.8%) had poor postoperative collateral formation. The univariate logistic regression analyses showed that age at operation (OR, 0.954; 95% CI, 0.908–1.003;p= 0.066), hemorrhagic site (OR, 4.694; 95% CI, 1.582–13.923;p= 0.005), and PCA involvement (OR, 3.474; 95% CI, 0.922–13.086;p= 0.066) may effect postoperative collateral formation. The multivariate logistic regression analyses showed that only anterior hemorrhage (OR, 5.222; 95% CI, 1.605–16.987;p= 0.006) was significantly related to good postoperative collateral formation.ConclusionAnterior hemorrhage was significantly related to good postoperative collateral formation after indirect bypass.