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Conference Paper: Two decades of experience in surgical revascularization of Moyamoya disease
Title | Two decades of experience in surgical revascularization of Moyamoya disease |
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Authors | |
Issue Date | 2020 |
Publisher | The Hong Kong Neurosurgical Society. |
Citation | 27th Annual Scientific Meeting of The Hong Kong Neurosurgical Society: Smart Hospital and Artificial Intelligence in Neurosurgery, Virtual Conference, Hong Kong, 18-19 December 2020 How to Cite? |
Abstract | Objective: Moyamoya disease (MMD) is a progressive steno-occlusive cerebral vasculopathy
with a formidable natural history if not intervened. A paradigm shift with more direct bypasses were performed in the past 5 years at our center. Revascularization outcomes were studied and comparison was made between the indirect and direct revascularization groups.
Methods: Retrospective review of all surgically treated MMD patients in a single neurosurgical unit from November 2000 to September 2020.
Results: A consecutive series of 53 patients with a mean follow-up of 73.0 months were included. 70.9% of the 86 operated hemispheres involved direct bypasses . For the past 5 years, peri-operative (<1 week) stroke rate was 6.82% per operated hemisphere. There was no significant difference in peri-operative stroke (p=.278) or hyperperfusion syndrome (p=.099) between the evascularization groups. Delayed stroke occurred in 8% of indirect and 1.67% of direct groups (p=.144). 94% of those who presented with transient ischemic attacks and underwent bypass had complete resolution of symptoms, compared to 60% in the indirect group (p=.056). The bypass cohort had lower mean mRS at last follow-up (0.63 vs 0.96, p=.033). Improved cerebral perfusion with adequate cerebral reserve was reached in 84% and 50% of the direct and indirect groups respectively (p=.005). Patency of bypass grafts was 94.6% at mean follow-up time of 29.4 months.
Conclusions: Direct bypass for treatment of MMD confers low peri-operative stroke and comparable incidence of hyperperfusion syndrome, with high rate of TIA symptom resolution, low stroke recurrence and superior angiographic outcomes. Long term graft patency rate is high. |
Description | Oral presentation - Free Paper V |
Persistent Identifier | http://hdl.handle.net/10722/295886 |
DC Field | Value | Language |
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dc.contributor.author | Sum, CHF | - |
dc.contributor.author | Cheng, KF | - |
dc.contributor.author | Ho, WWS | - |
dc.contributor.author | Lui, WM | - |
dc.date.accessioned | 2021-02-08T08:15:25Z | - |
dc.date.available | 2021-02-08T08:15:25Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | 27th Annual Scientific Meeting of The Hong Kong Neurosurgical Society: Smart Hospital and Artificial Intelligence in Neurosurgery, Virtual Conference, Hong Kong, 18-19 December 2020 | - |
dc.identifier.uri | http://hdl.handle.net/10722/295886 | - |
dc.description | Oral presentation - Free Paper V | - |
dc.description.abstract | Objective: Moyamoya disease (MMD) is a progressive steno-occlusive cerebral vasculopathy with a formidable natural history if not intervened. A paradigm shift with more direct bypasses were performed in the past 5 years at our center. Revascularization outcomes were studied and comparison was made between the indirect and direct revascularization groups. Methods: Retrospective review of all surgically treated MMD patients in a single neurosurgical unit from November 2000 to September 2020. Results: A consecutive series of 53 patients with a mean follow-up of 73.0 months were included. 70.9% of the 86 operated hemispheres involved direct bypasses . For the past 5 years, peri-operative (<1 week) stroke rate was 6.82% per operated hemisphere. There was no significant difference in peri-operative stroke (p=.278) or hyperperfusion syndrome (p=.099) between the evascularization groups. Delayed stroke occurred in 8% of indirect and 1.67% of direct groups (p=.144). 94% of those who presented with transient ischemic attacks and underwent bypass had complete resolution of symptoms, compared to 60% in the indirect group (p=.056). The bypass cohort had lower mean mRS at last follow-up (0.63 vs 0.96, p=.033). Improved cerebral perfusion with adequate cerebral reserve was reached in 84% and 50% of the direct and indirect groups respectively (p=.005). Patency of bypass grafts was 94.6% at mean follow-up time of 29.4 months. Conclusions: Direct bypass for treatment of MMD confers low peri-operative stroke and comparable incidence of hyperperfusion syndrome, with high rate of TIA symptom resolution, low stroke recurrence and superior angiographic outcomes. Long term graft patency rate is high. | - |
dc.language | eng | - |
dc.publisher | The Hong Kong Neurosurgical Society. | - |
dc.relation.ispartof | 27th Annual Scientific Meeting (Virtual Conference) of The Hong Kong Neurosurgical Society, 2020 | - |
dc.title | Two decades of experience in surgical revascularization of Moyamoya disease | - |
dc.type | Conference_Paper | - |
dc.identifier.email | Cheng, KF: kfckevin@hku.hk | - |
dc.identifier.email | Ho, WWS: howsw@hku.hk | - |
dc.identifier.email | Lui, WM: mattlui@hku.hk | - |
dc.identifier.hkuros | 321106 | - |
dc.publisher.place | Hong Kong | - |