Recognition of the Effect of Indirect Revascularization for Moyamoya Disease: The Balance Between the Stage Progression and Neoangiogenesis
ObjectiveTo explore the long-term progression of neoangiogenesis after indirect revascularization for moyamoya disease (MMD).MethodsWe enrolled patients who were diagnosed with MMD and treated by encephaloduroarteriosynangiosis (EDAS) surgery at our center from December 2002 through September 2009....
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.861187/full |
| _version_ | 1818268930955804672 |
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| author | Xiang-Yang Bao Qian-Nan Wang Xiao-Peng Wang Xiao-Peng Wang Ri-Miao Yang Zheng-Xing Zou Qian Zhang De-Sheng Li Lian Duan Lian Duan |
| author_facet | Xiang-Yang Bao Qian-Nan Wang Xiao-Peng Wang Xiao-Peng Wang Ri-Miao Yang Zheng-Xing Zou Qian Zhang De-Sheng Li Lian Duan Lian Duan |
| author_sort | Xiang-Yang Bao |
| collection | DOAJ |
| description | ObjectiveTo explore the long-term progression of neoangiogenesis after indirect revascularization for moyamoya disease (MMD).MethodsWe enrolled patients who were diagnosed with MMD and treated by encephaloduroarteriosynangiosis (EDAS) surgery at our center from December 2002 through September 2009. A comparative study between short-term (6–12 months) and long-term (duration ≥ 8 years) follow-up angiographies was performed. The development of collateral circulation through EDAS was graded according to the system described by the Matsushima grade system.ResultsA total of 78 patients who received indirect EDAS were enrolled in the study. The mean age at the first operation was 26.9 ± 15.0 years. The Matsushima grades of the same hemisphere were higher at the long-term follow-up compared with the short-term follow-up. Importantly, no attenuation was observed in any hemisphere during the long-term follow-up. In total, 51 hemispheres (32.7%) and 26 hemispheres (16.6%) had progression during the short-term and the long-term follow-up, respectively. The ipsilateral Suzuki stage showed a significant negative correlation with progression pace. Furthermore, higher Suzuki stages were significantly correlated with the postsurgical Matsushima grade at both time points. A total of nine strokes (11.5%) occurred in 78 patients was reported at the long-term follow-up. The annual incidence rate of recurrent strokes was higher for the stage progression group than for the stable group.ConclusionFor patients with MMD, postsurgical neoangiogenesis after indirect bypass continuously improved with time. The short-term progression of the internal carotid artery (ICA) might be attributed to cerebral revascularization, while the long-term progression should be attributed to the natural progression of the disease. |
| first_indexed | 2024-12-12T20:46:19Z |
| format | Article |
| id | doaj.art-b6ea06c58b5e451d8d09b25dd0daeed2 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-12T20:46:19Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-b6ea06c58b5e451d8d09b25dd0daeed22022-12-22T00:12:34ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-05-011310.3389/fneur.2022.861187861187Recognition of the Effect of Indirect Revascularization for Moyamoya Disease: The Balance Between the Stage Progression and NeoangiogenesisXiang-Yang Bao0Qian-Nan Wang1Xiao-Peng Wang2Xiao-Peng Wang3Ri-Miao Yang4Zheng-Xing Zou5Qian Zhang6De-Sheng Li7Lian Duan8Lian Duan9Department of Neurosurgery, Chinese PLA General Hospital (Former Department of Neurosurgery, The Fifth Medical Center of Chinese PLA General Hospital), Beijing, ChinaDepartment of Neurosurgery, Chinese PLA General Hospital (Former Department of Neurosurgery, The Eighth Medical Center of Chinese PLA General Hospital), Beijing, ChinaDepartment of Neurosurgery, Chinese PLA General Hospital (Former Department of Neurosurgery, The Fifth Medical Center of Chinese PLA General Hospital), Beijing, ChinaDepartment of Neurosurgery, 307th Hospital of People's Liberation Army, 307 Clinical College, Anhui Medical University, Hefei, ChinaDepartment of Neurosurgery, Chinese PLA General Hospital (Former Department of Neurosurgery, The Fifth Medical Center of Chinese PLA General Hospital), Beijing, ChinaDepartment of Neurosurgery, Chinese PLA General Hospital (Former Department of Neurosurgery, The Fifth Medical Center of Chinese PLA General Hospital), Beijing, ChinaDepartment of Neurosurgery, Chinese PLA General Hospital (Former Department of Neurosurgery, The Fifth Medical Center of Chinese PLA General Hospital), Beijing, ChinaDepartment of Neurosurgery, Chinese PLA General Hospital (Former Department of Neurosurgery, The Fifth Medical Center of Chinese PLA General Hospital), Beijing, ChinaDepartment of Neurosurgery, Chinese PLA General Hospital (Former Department of Neurosurgery, The Fifth Medical Center of Chinese PLA General Hospital), Beijing, ChinaDepartment of Neurosurgery, 307th Hospital of People's Liberation Army, 307 Clinical College, Anhui Medical University, Hefei, ChinaObjectiveTo explore the long-term progression of neoangiogenesis after indirect revascularization for moyamoya disease (MMD).MethodsWe enrolled patients who were diagnosed with MMD and treated by encephaloduroarteriosynangiosis (EDAS) surgery at our center from December 2002 through September 2009. A comparative study between short-term (6–12 months) and long-term (duration ≥ 8 years) follow-up angiographies was performed. The development of collateral circulation through EDAS was graded according to the system described by the Matsushima grade system.ResultsA total of 78 patients who received indirect EDAS were enrolled in the study. The mean age at the first operation was 26.9 ± 15.0 years. The Matsushima grades of the same hemisphere were higher at the long-term follow-up compared with the short-term follow-up. Importantly, no attenuation was observed in any hemisphere during the long-term follow-up. In total, 51 hemispheres (32.7%) and 26 hemispheres (16.6%) had progression during the short-term and the long-term follow-up, respectively. The ipsilateral Suzuki stage showed a significant negative correlation with progression pace. Furthermore, higher Suzuki stages were significantly correlated with the postsurgical Matsushima grade at both time points. A total of nine strokes (11.5%) occurred in 78 patients was reported at the long-term follow-up. The annual incidence rate of recurrent strokes was higher for the stage progression group than for the stable group.ConclusionFor patients with MMD, postsurgical neoangiogenesis after indirect bypass continuously improved with time. The short-term progression of the internal carotid artery (ICA) might be attributed to cerebral revascularization, while the long-term progression should be attributed to the natural progression of the disease.https://www.frontiersin.org/articles/10.3389/fneur.2022.861187/fullmoyamoyaneoangiogenesisencephaloduroarteriosynangiosislong-termMatsushima grade |
| spellingShingle | Xiang-Yang Bao Qian-Nan Wang Xiao-Peng Wang Xiao-Peng Wang Ri-Miao Yang Zheng-Xing Zou Qian Zhang De-Sheng Li Lian Duan Lian Duan Recognition of the Effect of Indirect Revascularization for Moyamoya Disease: The Balance Between the Stage Progression and Neoangiogenesis Frontiers in Neurology moyamoya neoangiogenesis encephaloduroarteriosynangiosis long-term Matsushima grade |
| title | Recognition of the Effect of Indirect Revascularization for Moyamoya Disease: The Balance Between the Stage Progression and Neoangiogenesis |
| title_full | Recognition of the Effect of Indirect Revascularization for Moyamoya Disease: The Balance Between the Stage Progression and Neoangiogenesis |
| title_fullStr | Recognition of the Effect of Indirect Revascularization for Moyamoya Disease: The Balance Between the Stage Progression and Neoangiogenesis |
| title_full_unstemmed | Recognition of the Effect of Indirect Revascularization for Moyamoya Disease: The Balance Between the Stage Progression and Neoangiogenesis |
| title_short | Recognition of the Effect of Indirect Revascularization for Moyamoya Disease: The Balance Between the Stage Progression and Neoangiogenesis |
| title_sort | recognition of the effect of indirect revascularization for moyamoya disease the balance between the stage progression and neoangiogenesis |
| topic | moyamoya neoangiogenesis encephaloduroarteriosynangiosis long-term Matsushima grade |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.861187/full |
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