Cargando…
Intraoperative Hemodynamics of Parasylvian Cortical Arteries for Predicting Postoperative Symptomatic Cerebral Hyperperfusion after Direct Revascularization in Patients with Moyamoya Disease: A Preliminary Study
Objective. The search for methods by which to predict the risks of cerebral hyperperfusion syn-drome (CHS) in adults with moyamoya disease (MMD), including those utilizing new biomarkers, still deserves further research. The objective of this study was to investigate the association between the hemo...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253873/ https://www.ncbi.nlm.nih.gov/pubmed/37298050 http://dx.doi.org/10.3390/jcm12113855 |
_version_ | 1785056510076780544 |
---|---|
author | Shi, Zhiyong Wu, Lingyun Wang, Yi Li, Wei Wang, Juan Yang, Yongbo Hang, Chunhua |
author_facet | Shi, Zhiyong Wu, Lingyun Wang, Yi Li, Wei Wang, Juan Yang, Yongbo Hang, Chunhua |
author_sort | Shi, Zhiyong |
collection | PubMed |
description | Objective. The search for methods by which to predict the risks of cerebral hyperperfusion syn-drome (CHS) in adults with moyamoya disease (MMD), including those utilizing new biomarkers, still deserves further research. The objective of this study was to investigate the association between the hemodynamics of parasylvian cortical arteries (PSCAs) and postoperative CHS. Methods. A consecutive number of adults with MMD who had undergone direct bypass between September 2020 and December 2022 were recruited. Intraoperative microvascular doppler ultrasonography (MDU) was performed to evaluate the hemodynamics of PSCAs. The intraoperative flow direction, mean value of velocity (MVV) of recipient artery (RA) and bypass graft were recorded. According to flow direction after bypass, RA was divided into entering sylvian (RA.ES) and leaving sylvian (RA.LS) subtypes. Univariate, multivariate, and ROC analyses of the risk factors for postoperative CHS were performed. Results. A total of 16 (15.09%) cases in 106 consecutive hemispheres (101 patients) sat-isfied the postoperative CHS criteria. According to univariate analysis, advanced Suzuki stage, MVV of RA before bypass, and fold increase of MVV in RA.ES after bypass were significantly associated with postoperative CHS (p < 0.05). Multivariate analysis indicated that left-operated hemisphere (OR (95%CI), 4.58 (1.05–19.97), p = 0.043), advanced Suzuki stage (OR (95%CI), 5.47 (1.99–15.05), p = 0.017), and fold increase of MVV in RA.ES (OR (95%CI), 1.17 (1.06–1.30), p = 0.003) were statistically significantly associated with the occurrence of CHS. The cut-off value of fold increase of MVV in RA.ES was 2.7-fold (p < 0.05). Conclusions. Left-operated hemisphere, advanced Suzuki stage, and postoperative fold increase of MVV in RA.ES were potential risk factors for postoperative CHS. Intraoperative MDU was useful for evaluating hemodynamics and predicting CHS. |
format | Online Article Text |
id | pubmed-10253873 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-102538732023-06-10 Intraoperative Hemodynamics of Parasylvian Cortical Arteries for Predicting Postoperative Symptomatic Cerebral Hyperperfusion after Direct Revascularization in Patients with Moyamoya Disease: A Preliminary Study Shi, Zhiyong Wu, Lingyun Wang, Yi Li, Wei Wang, Juan Yang, Yongbo Hang, Chunhua J Clin Med Article Objective. The search for methods by which to predict the risks of cerebral hyperperfusion syn-drome (CHS) in adults with moyamoya disease (MMD), including those utilizing new biomarkers, still deserves further research. The objective of this study was to investigate the association between the hemodynamics of parasylvian cortical arteries (PSCAs) and postoperative CHS. Methods. A consecutive number of adults with MMD who had undergone direct bypass between September 2020 and December 2022 were recruited. Intraoperative microvascular doppler ultrasonography (MDU) was performed to evaluate the hemodynamics of PSCAs. The intraoperative flow direction, mean value of velocity (MVV) of recipient artery (RA) and bypass graft were recorded. According to flow direction after bypass, RA was divided into entering sylvian (RA.ES) and leaving sylvian (RA.LS) subtypes. Univariate, multivariate, and ROC analyses of the risk factors for postoperative CHS were performed. Results. A total of 16 (15.09%) cases in 106 consecutive hemispheres (101 patients) sat-isfied the postoperative CHS criteria. According to univariate analysis, advanced Suzuki stage, MVV of RA before bypass, and fold increase of MVV in RA.ES after bypass were significantly associated with postoperative CHS (p < 0.05). Multivariate analysis indicated that left-operated hemisphere (OR (95%CI), 4.58 (1.05–19.97), p = 0.043), advanced Suzuki stage (OR (95%CI), 5.47 (1.99–15.05), p = 0.017), and fold increase of MVV in RA.ES (OR (95%CI), 1.17 (1.06–1.30), p = 0.003) were statistically significantly associated with the occurrence of CHS. The cut-off value of fold increase of MVV in RA.ES was 2.7-fold (p < 0.05). Conclusions. Left-operated hemisphere, advanced Suzuki stage, and postoperative fold increase of MVV in RA.ES were potential risk factors for postoperative CHS. Intraoperative MDU was useful for evaluating hemodynamics and predicting CHS. MDPI 2023-06-05 /pmc/articles/PMC10253873/ /pubmed/37298050 http://dx.doi.org/10.3390/jcm12113855 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Shi, Zhiyong Wu, Lingyun Wang, Yi Li, Wei Wang, Juan Yang, Yongbo Hang, Chunhua Intraoperative Hemodynamics of Parasylvian Cortical Arteries for Predicting Postoperative Symptomatic Cerebral Hyperperfusion after Direct Revascularization in Patients with Moyamoya Disease: A Preliminary Study |
title | Intraoperative Hemodynamics of Parasylvian Cortical Arteries for Predicting Postoperative Symptomatic Cerebral Hyperperfusion after Direct Revascularization in Patients with Moyamoya Disease: A Preliminary Study |
title_full | Intraoperative Hemodynamics of Parasylvian Cortical Arteries for Predicting Postoperative Symptomatic Cerebral Hyperperfusion after Direct Revascularization in Patients with Moyamoya Disease: A Preliminary Study |
title_fullStr | Intraoperative Hemodynamics of Parasylvian Cortical Arteries for Predicting Postoperative Symptomatic Cerebral Hyperperfusion after Direct Revascularization in Patients with Moyamoya Disease: A Preliminary Study |
title_full_unstemmed | Intraoperative Hemodynamics of Parasylvian Cortical Arteries for Predicting Postoperative Symptomatic Cerebral Hyperperfusion after Direct Revascularization in Patients with Moyamoya Disease: A Preliminary Study |
title_short | Intraoperative Hemodynamics of Parasylvian Cortical Arteries for Predicting Postoperative Symptomatic Cerebral Hyperperfusion after Direct Revascularization in Patients with Moyamoya Disease: A Preliminary Study |
title_sort | intraoperative hemodynamics of parasylvian cortical arteries for predicting postoperative symptomatic cerebral hyperperfusion after direct revascularization in patients with moyamoya disease: a preliminary study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253873/ https://www.ncbi.nlm.nih.gov/pubmed/37298050 http://dx.doi.org/10.3390/jcm12113855 |
work_keys_str_mv | AT shizhiyong intraoperativehemodynamicsofparasylviancorticalarteriesforpredictingpostoperativesymptomaticcerebralhyperperfusionafterdirectrevascularizationinpatientswithmoyamoyadiseaseapreliminarystudy AT wulingyun intraoperativehemodynamicsofparasylviancorticalarteriesforpredictingpostoperativesymptomaticcerebralhyperperfusionafterdirectrevascularizationinpatientswithmoyamoyadiseaseapreliminarystudy AT wangyi intraoperativehemodynamicsofparasylviancorticalarteriesforpredictingpostoperativesymptomaticcerebralhyperperfusionafterdirectrevascularizationinpatientswithmoyamoyadiseaseapreliminarystudy AT liwei intraoperativehemodynamicsofparasylviancorticalarteriesforpredictingpostoperativesymptomaticcerebralhyperperfusionafterdirectrevascularizationinpatientswithmoyamoyadiseaseapreliminarystudy AT wangjuan intraoperativehemodynamicsofparasylviancorticalarteriesforpredictingpostoperativesymptomaticcerebralhyperperfusionafterdirectrevascularizationinpatientswithmoyamoyadiseaseapreliminarystudy AT yangyongbo intraoperativehemodynamicsofparasylviancorticalarteriesforpredictingpostoperativesymptomaticcerebralhyperperfusionafterdirectrevascularizationinpatientswithmoyamoyadiseaseapreliminarystudy AT hangchunhua intraoperativehemodynamicsofparasylviancorticalarteriesforpredictingpostoperativesymptomaticcerebralhyperperfusionafterdirectrevascularizationinpatientswithmoyamoyadiseaseapreliminarystudy |