Predictive factors for acute thrombogenesis occurring immediately after bypass procedure for moyamoya disease
Predictive factors for acute thrombogenesis occurring immediately after bypass procedure for moyamoya disease
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DOI：
10.1007/s10143-019-01086-4
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发表时间：
2020-04-01
影响因子：
2.8
通讯作者：
Mikuni, Nobuhiro
中科院分区：
文献类型：
--
作者：
Mikami, Takeshi;Suzuki, Hime;Mikuni, Nobuhiro
颅外到颅内（EC-IC）搭桥手术是烟雾病和其他疾病患者的有效治疗方法。一些烟雾病患者在搭桥手术后，吻合口有急性血栓形成的风险。本研究的目的是研究急性血栓形成的危险因素并确定有效的对策。这项研究包括 48 名患有烟雾病的患者（66 例 EC-IC 旁路手术）和 52 名没有烟雾病的对照患者（54 例手术）。比较烟雾病组和对照组之间急性血栓形成的发展情况。在烟雾病组中，评估了急性血栓形成的临床和放射学特征。在急性血栓形成患者中，对技术问题的原因进行了回顾性检查。烟雾病组急性血栓发生率显着高于对照组。在烟雾病组中，七名患者观察到急性血栓形成。在烟雾病组中，有急性血栓形成的患者的磁共振血管造影（MRA）评分显着高于无急性血栓形成的患者。在多变量分析中，烟雾病急性血栓形成的预测因素是高 MRA 评分（比值比，2.336；p = 0.009）。在烟雾病的 EC-IC 搭桥手术中，应考虑急性血栓形成以获得高通畅率，特别是对于 MRA 评分高的患者。如果采取适当的对策，急性血栓形成不会影响发病率；因此，白色血栓的预测和识别对于搭桥手术的成功非常重要。
Extracranial-to-intracranial (EC-IC) bypass surgery is an effective treatment for patients with moyamoya disease and other conditions. Some patients with moyamoya disease have a risk of acute thrombogenesis at the anastomotic site just after bypass surgery. The purpose of this study was to study risk factors of acute thrombogenesis and determine effective countermeasures. This study included 48 patients (66 EC-IC bypass procedures) with moyamoya disease and 52 controls (54 procedures) without moyamoya disease. The development of acute thrombogenesis was compared between the moyamoya disease and control groups. In the moyamoya disease group, clinical and radiological characteristics were assessed with respect to acute thrombogenesis. In the patients with acute thrombogenesis, causes of technical problems were retrospectively examined. The incidence of acute thrombogenesis was significantly higher in the moyamoya disease group than those in the control group. In the moyamoya disease group, acute thrombogenesis was observed in seven patients. In the moyamoya disease group, the magnetic resonance angiography (MRA) scores were significantly higher in patients with acute thrombogenesis than those in the patients without acute thrombogenesis. In the multivariate analysis, the predictive factor of acute thrombogenesis in moyamoya disease was a high MRA score (odds ratio, 2.336; p = 0.009). During EC-IC bypass surgery for moyamoya disease, acute thrombogenesis should be considered to obtain a high patency rate, particularly in patients with high MRA scores. Acute thrombogenesis will not influence morbidity if proper countermeasures are followed; therefore, the prediction and recognition of white thrombus are important for a successful bypass surgery.