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01-10-2018 | Original Communication

Moyamoya angiopathy: early postoperative course within 3 months after STA–MCA–bypass surgery in Europe—a retrospective analysis of 64 procedures

Authors: Markus Kraemer, Jasmin Sassen, Rusen Karakaya, Jan Claudius Schwitalla, Jonas Graf, Philipp Albrecht, Hans-Peter Hartung, Rolf R. Diehl, Peter Berlit, Rudolf Laumer, Frank Diesner

Published in: Journal of Neurology | Issue 10/2018

Abstract

Background

Despite the consensus on the necessity of revascularizing surgery in Moyamoya angiopathy in Asia, the indication in Caucasian Moyamoya patients is discussed controversially.

Objective

The safety of revascularizing surgery in Europe should be clarified.

Methods

This study retrospectively analyzed the rate of complications as well as clinical symptoms within the first 3 months after bypass surgery between superficial temporal artery and middle cerebral artery (STA–MCA).

Results

64 direct bypass procedures in 45 patients (95.5% Caucasians) were analyzed. The magnetic resonance imaging at day 6 showed subdural hematoma in 60.3%. The mean diameter of these hematomas on magnetic resonance imaging was 5.1 mm (SD 3.4 mm) and increased in 25% at follow-up. No difference was found between those patients with early (day 1) or late (day 7) restarts of antiplatelet therapy. Magnetic resonance imaging at day 6 revealed hyperperfusion syndrome after six of 64 procedures (9.3%). Three of these six had clinical symptoms; two-thirds were transient within seconds. Magnetic resonance imaging depicted stroke after seven procedures (10.9%). Five of these seven patients had no new symptoms. Altogether, after ten procedures (15%), patients complained about clinical symptoms. These were all transient. No new transient ischemic attacks occurred during the 3 month follow-up and no new lesions were detected in magnetic resonance imaging. Only two patients underwent surgery for asymptomatic subdural hematoma. All other subdural hematomas resolved spontaneously.

Conclusion

Revasculating surgery is a safe procedure in Caucasian patients with Moyamoya angiopathy. The observed complications have a good prognosis.

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Title: Moyamoya angiopathy: early postoperative course within 3 months after STA–MCA–bypass surgery in Europe—a retrospective analysis of 64 procedures
Authors: Markus Kraemer
Jasmin Sassen
Rusen Karakaya
Jan Claudius Schwitalla
Jonas Graf
Philipp Albrecht
Hans-Peter Hartung
Rolf R. Diehl
Peter Berlit
Rudolf Laumer
Frank Diesner
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 10/2018
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-018-8997-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Moyamoya angiopathy: early postoperative course within 3 months after STA–MCA–bypass surgery in Europe—a retrospective analysis of 64 procedures

Abstract

Background

Objective

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusion

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