Abstract
BackgroundThis systematic review and meta-analysis aimed to clarify the risk factors for postoperative stroke in adult patients with moyamoya disease (MMD).MethodsWe comprehensively searched MEDLINE/PubMed, Web of Science, and Cochrane Library for eligible published literature with regard to the risk factors and postoperative complications in adult patients with MMD. Statistical analysis was conducted using Stata version 12.0. Pooled odds ratio (OR) with 95% confidence interval (CI) were assessed for each risk factor.ResultsThere were 8 studies encompassing 1649 patients who underwent surgery with MMD were selected for analysis. Preoperative ischemic event significantly increase the risk of postoperative stroke events (OR = 1.40; 95%CI = 1.02–1.92; P = 0.039). PCA involvement correlate with an increased risk of post-infarction (OR = 4.60; 95%CI = 2.61–8.11; P = 0.000). Compared to direct bypass, patients who underwent indirect bypass or combined bypass could significantly increase the risk of postoperative stroke events. (OR = 1.17; 95%CI = 1.03–1.33; p = 0.017). MMD patients with diabetes were associated with an increased risk of postoperative stroke events (OR = 4.02, 95% CI = 1.59–10.16; p = 0.003). MMD patients with hypertension, age at onset and male sex were not associated with an increased risk of postoperative stroke events (P > 0.05).ConclusionsThis systematic review and meta-analysis indicated that preoperative ischemic events, PCA involvement and diabetes were independent risk factors for postoperative stroke in MMD patients. Therefore, in order to ensure the curative effect of patients with MMD, it is very necessary to detect these risk factors and prevent postoperative complications in time.
Highlights
Moyamoya disease (MMD) is an abnormal cerebrovascular characterized by progressive stenosis or occlusion of the intracranial vessels, resulting in the formation of a fine vascular network at the base of the brain [1]
posterior cerebral artery (PCA) involvement correlate with an increased risk of post-infarction (OR = 4.60; 95%confidence interval (CI) = 2.61–8.11; P = 0.000), whereas there is no association between PCA
moyamoya disease (MMD) patients with diabetes were associated with an increased risk of postoperative stroke events (OR = 4.02, 95% CI = 1.59–10.16; p = 0.003)
Summary
Moyamoya disease (MMD) is an abnormal cerebrovascular characterized by progressive stenosis or occlusion of the intracranial vessels, resulting in the formation of a fine vascular network (the “moyamoya” vessels) at the base of the brain [1]. Revascularization surgery is the most effective treatment for MMD. The incidence of postoperative complications, such as postoperative ischemic or hemorrhagic events and cerebral hyperperfusion syndrome (CHS), has been increasingly reported. These procedure-related complications can seriously affect the prognosis [4]. This systematic review and meta-analysis aimed to clarify the risk factors for postoperative stroke in adult patients with moyamoya disease (MMD)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
