Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jan 17;20(1):28.
doi: 10.1186/s12883-020-1612-z.

Postoperative collateral formation after indirect bypass for hemorrhagic moyamoya disease

Peicong Ge  1   2   3   4   5 , Qian Zhang  1   2   3   4   5 , Xun Ye  1   2   3   4   5 , Xingju Liu  1   2   3   4   5 , Xiaofeng Deng  1   2   3   4   5 , Jia Wang  1   2   3   4   5 , Rong Wang  1   2   3   4   5 , Yan Zhang  1   2   3   4   5 , Dong Zhang  1   2   3   4   5 , Jizong Zhao  6   7   8   9   10   11
Affiliations

Postoperative collateral formation after indirect bypass for hemorrhagic moyamoya disease

Peicong Ge et al. BMC Neurol. .

Abstract

Background: The 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.

Methods: All 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.

Results: Six-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.

Conclusion: Anterior hemorrhage was significantly related to good postoperative collateral formation after indirect bypass.

Keywords: Digital subtraction angiography; Hemorrhage; Indirect bypass; Moyamoya disease; Postoperative collateral formation.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the study participants
Fig. 2
Fig. 2
Postoperative collateral formation was evaluated with the Matsushima scale: A, more than 2/3 of the MCA distribution; B, between 2/3 and 1/3 of the MCA distribution. C, slight or none
See this image and copyright information in PMC

References

    1. Scott RM, Smith ER. Moyamoya disease and moyamoya syndrome. N Engl J Med. 2009;360(12):1226–1237. - PubMed
    1. Kuroda S, Houkin K. Moyamoya disease: current concepts and future perspectives. Lancet Neurol. 2008;7(11):1056–1066. - PubMed
    1. Kim JS. Moyamoya disease: epidemiology, clinical features, and diagnosis. J Stroke. 2016;18(1):2–11. - PMC - PubMed
    1. Kim T, Oh CW, Bang JS, Kim JE, Cho WS. Moyamoya disease: treatment and outcomes. J Stroke. 2016;18(1):21–30. - PMC - PubMed
    1. Miyamoto S, Yoshimoto T, Hashimoto N, Okada Y, Tsuji I, Tominaga T, Nakagawara J, Takahashi JC. JAM trial investigators: effects of extracranial-intracranial bypass for patients with hemorrhagic moyamoya disease: results of the Japan adult Moyamoya trial. Stroke. 2014;45(5):1415–1421. - PubMed

LinkOut - more resources