Document Type
Article
Publication Date
3-7-2025
Abstract
INTRODUCTION: Moyamoya disease (MMD) is a chronic cerebrovascular disorder characterized by progressive stenosis or occlusion of the internal carotid arteries and the development of collateral moyamoya vessels. Surgical revascularization is commonly used to prevent future ischemic events in ischemic-type MMD, but there remains a high rate of stroke perioperatively. This study aims to analyze the predictive factors for perioperative stroke in patients with ischemic-type MMD undergoing surgical revascularization using a large multicenter database.
METHODS: We conducted a multicenter retrospective study in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. This study included patients with ischemic-type MMD who underwent surgical revascularization across 13 academic institutions in North America. Data were collected and analyzed on a per-hemisphere basis, covering patient demographics, disease characteristics, procedural details, and outcomes. Statistical analyses were performed using Stata (V.17.0), comparing baseline characteristics, and using univariable and multivariable logistic regression to identify predictors of perioperative stroke.
RESULTS: A total of 301 patients with ischemic-type MMD underwent surgical revascularization, with 34 patients (11.3 %) experiencing perioperative stroke. Patients who experienced perioperative stroke had a mean age of 43.6 years (SD 14.0) compared to 40.0 years (SD 13.9) in those without perioperative stroke (P = 0.16). Hypertension was significantly more prevalent in the perioperative stroke group (73.5 % vs. 47.9 %, P = 0.005). Current smoking was also more common in the perioperative stroke group (55.8 % vs. 38.2 %, P = 0.04). Multivariate logistic regression identified hypertension (OR 2.32, 95 % CI 1.01 to 5.37, P = 0.04) and current smoking (OR 2.28, 95 % CI 1.04 to 4.97, P = 0.03) as significant independent predictors of perioperative stroke.
CONCLUSION: Hypertension and smoking were significant predictors of perioperative stroke in patients with ischemic-type MMD undergoing surgical revascularization. These findings emphasize the importance of managing risk factors in ischemic-type MMD. Further prospective studies are needed to validate these findings.
Recommended Citation
Musmar, Basel; Roy, Joanna M.; Abdalrazeq, Hammam; Atallah, Elias; El Naamani, Kareem; Chen, Ching-Jen; Jabre, Roland; Saad, Hassan; Grossberg, Jonathan A.; Dmytriw, Adam A.; Patel, Aman B.; Khorasanizadeh, Mirhojjat; Ogilvy, Christopher S.; Thomas, Ajith J.; Monteiro, Andre; Siddiqui, Adnan; Cortez, Gustavo M.; Hanel, Ricardo A.; Porto, Guilherme; Spiotta, Alejandro M.; Piscopo, Anthony J.; Hasan, David M.; Ghorbani, Mohammad; Weinberg, Joshua; Nimjee, Shahid M.; Bekelis, Kimon; Salem, Mohamed M.; Burkhardt, Jan-Karl; Zetchi, Akli; Matouk, Charles; Howard, Brian M.; Lai, Rosalind; Du, Rose; Abbas, Rawad; Sioutas, Georgios S; Amllay, Abdelaziz; Munoz, Alfredo; Herial, Nabeel A; Tjoumakaris, Stavropoula I; Gooch, Michael Reid; Rosenwasser, Robert H; and Jabbour, Pascal, "Predictors of Perioperative Stroke in Patients With Ischemic-Type Moyamoya Disease Treated With Surgical Revascularization: A Retrospective Multicenter Study" (2025). Department of Neurosurgery Faculty Papers. Paper 252.
https://jdc.jefferson.edu/neurosurgeryfp/252
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
PubMed ID
40057254
Language
English
Included in
Cardiovascular Diseases Commons, Investigative Techniques Commons, Nervous System Diseases Commons, Neurosurgery Commons
Comments
This article is the author's final published version in Journal of Stroke and Cerebrovascular Diseases, Volume 34, Issue 5, 2025, Article number 108277.
The published version is available at https://doi.org/j.jstrokecerebrovasdis.2025.108277.
Copyright © 2025 The Author(s)