The preoperative focal cerebral blood flow status may be associated with slow flow in the bypass graft after combined surgery for moyamoya disease-Reference-Cited by-同舟云学术

The preoperative focal cerebral blood flow status may be associated with slow flow in the bypass graft after combined surgery for moyamoya disease

Published:2022-11-04 Issue: Volume:13 Page:511
ISSN:2152-7806
Container-title:Surgical Neurology International
language:en
Short-container-title:

Author:

Araki Yoshio¹,Yokoyama Kinya¹,Uda Kenji¹,Kanamori Fumiaki¹,Mamiya Takashi¹,Takayanagi Kai¹,Ishii Kazuki¹,Shintai Kazunori²,Nishihori Masahiro¹,Tsukada Tetsuya²,Takeuchi Kazuhito¹,Tanahashi Kuniaki¹,Nagata Yuichi¹,Nishimura Yusuke¹,Tanei Takafumi¹,Nagashima Yoshitaka¹,Muraoka Shinsuke³,Izumi Takashi¹,Seki Yukio²,Saito Ryuta¹

Affiliation:

1. Department of Neurosurgery, Nagoya University, Nagoya, Japan

2. Department of Neurosurgery, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan

3. Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan.

Abstract

Background: The aim of this study was to investigate the association between early postoperative slow flow in bypass grafts and preoperative focal cerebral blood flow (CBF) in patients who underwent combined surgery for moyamoya disease (MMD). Methods: The subjects were 18 patients (22 surgeries) who underwent single photon emission computed tomography (SPECT) before surgery. The CBF value of the middle cerebral artery territory was extracted from the SPECT data, and the value relative to the ipsilateral cerebellar CBF (relative CBF, or RCBF) was calculated. The association between RCBF and early postoperative slow flow in the bypass graft was investigated. In addition, the correlation between the revascularization effect and preoperative RCBF was analyzed. Results: In four of 22 surgeries (18.2%), slow flow in the bypass graft was identified in the early postoperative period. Preoperative RCBF in the slow flow and patent groups was 0.86 ± 0.15 and 0.87 ± 0.15, respectively, with no significant difference (P = 0.72). The signal intensity of four slow-flowed bypasses was improved in all cases on magnetic resonance angiography images captured during the chronic phase (mean of 3.3 months postoperatively). The revascularization scores were 2 ± 0.82 and 2.1 ± 0.68 in the slow flow and patent groups, respectively, and did not differ significantly (P = 0.78). A significant correlation was not observed between preoperative RCBF and the revascularization effect. Conclusion: No significant association was observed between preoperative RCBF and early postoperative slow flow in bypass grafts in patients with MMD undergoing combined surgery. Given the high rate of improved depiction of slow-flowed bypass in the chronic postoperative phase, the conceptual significance of an opportune surgical intervention is to maintain CBF by supporting the patient’s own intracranial-extracranial conversion function.

Publisher

Scientific Scholar

Subject

Neurology (clinical),Surgery

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