Long-Term Surgical Outcome of Indirect Bypass Surgery in Young Children With Moyamoya Disease

被引:0
作者
Ha, Eun Jin [1 ,2 ,3 ]
Phi, Ji Hoon [1 ,2 ]
Lee, Ji Yeoun [1 ,2 ,4 ]
Koh, Eun Jung [1 ,2 ]
Kim, Kyung Hyun [1 ,2 ]
Wang, Kyu-Chang [5 ]
Cho, Byung-Kyu [6 ]
Kim, Seung-Ki [1 ,2 ,7 ]
机构
[1] Seoul Natl Univ, Seoul Natl Univ Hosp, Coll Med, Dept Neurosurg, Seoul, Seoul, South Korea
[2] Seoul Natl Univ, Childrens Hosp, Div Pediat Neurosurg, Seoul, South Korea
[3] Seoul Natl Univ Hosp, Dept Crit Care Med, Seoul, South Korea
[4] Seoul Natl Univ, Coll Med, Dept Anat & Cell Biol, Seoul, South Korea
[5] Natl Canc Ctr, Ctr Rare Canc, Goyang, Gyeonggi Do, South Korea
[6] Armed Forces Capital Hosp, Dept Neurosurg, Seongnam, Gyeonggi Do, South Korea
[7] Seoul Natl Univ, Seoul Natl Univ Hosp, Coll Med, Div Pediat Neurosurg,Dept Neurosurg, 101 Daehak Ro, Seoul 03080, South Korea
基金
新加坡国家研究基金会;
关键词
Children; Infant; Moyamoya disease; Indirect revascularization; Stroke; Outcomes; CEREBRAL INFARCTION; PEDIATRIC-PATIENTS; CLINICAL-FEATURES; RISK-FACTORS; REVASCULARIZATION; EPILEPSY;
D O I
暂无
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND: The prognosis of moyamoya disease (MMD) in young children (younger than 4 years) is worse than that of older adults. The effectiveness of surgery is still inconclusive.OBJECTIVE: To evaluate long-term outcomes after indirect bypass in young children with MMD.METHODS: A total of 1417 MMD children underwent indirect bypass from August 1988 to October 2020. This study included 135 patients who were younger than 4 years at the time of surgery. The clinical features and surgical outcomes of these patients were assessed. We analyzed the long-term outcome of 102 children who were followed up for more than 5 years (mean: 18.8 years, range: 5-27.3 years). Cross-sectional analysis was performed to evaluate overall outcomes based on the Lansky Play Performance Scale (LPS). The annual risk of symptomatic stroke after surgery was calculated with a person-year method, and the event-free survival rate was evaluated using the Kaplan-Meier method.RESULTS: The overall clinical outcome was favorable (LPS = 80) in 88% of the patients. The overall postoperative adverse event rate was 15%, including 1 death. At the last follow-up, 86% of patients who had seizures at diagnosis were seizure-free. During the follow-up, there were 3 symptomatic infarctions on the operated hemisphere (postoperative 3, 3, and 10 months each). There was no hemorrhagic event. The annual infarction rate was 0.16% per person-year. The 20-year event-free survival rates for symptomatic infarction were 97%.CONCLUSION: Indirect bypass could provide a satisfactory long-term outcome and prevent recurrent stroke in young children with MMD.
引用
收藏
页码:901 / 909
页数:9
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