Keywords
Revascularization
Complications
Driving factors
Submitted : 2023-02-26
Accepted : 2023-03-13
Published : 2023-03-28
Abstract
Objective: In this study, the driving factors of complications in patients with moyamoya disease after revascularization are analyzed and discussed. Methods: A total of 1500 cases with moyamoya disease after revascularization in Yunan Shuifu People’s Hosptial and Beijing University of Chinese Medicine Third Affiliated Hospital from November 2017 to November 2022 were selected retrospectively, and they were divided into an observation group (with postoperative complications) and a control group (with no complications), resulting in 313 cases and 1187 cases in each group, respectively. Univariate and multivariate analysis were performed to screen out independent risk factors for complications in patients with moyamoya disease after revascularization. Results: Univariate analysis showed that the proportion of patients with cerebral ischemia, history of hypertension, and modified Rankin scale (mRs) score of 3-5 in the observation group were significantly higher than those in the control group. Complications were used as the dependent variable, and the indicators with statistically significant differences based on the univariate analysis were included as independent variables in the logistic regression analysis. The results showed that the first symptoms before operation were cerebral ischemia, history of hypertension, and mRs score of 3 to 5 were risk factors for complications in patients with moyamoya disease after revascularization, and there were significant differences in the data (OR = 1.781, 1.811, 1.859, all P < 0.05). Conclusion: Cerebral ischemia is the first symptom before operation, and history of hypertension and mRs score of 3 to 5 are all risk factors for complications in patients with moyamoya disease after revascularization. Therefore, clinical prevention should be strengthened, and corresponding treatment measures should be given in time to reduce the risk of postoperative complications in patients with moyamoya disease.
References
Araki Y, Uda K, Yokoyama K, et al., 2022, Risk Factors for Cerebral Infarction Early After Revascularization in Children Younger than 5 Years of Age with Moyamoya Disease. World neurosurgery, 16(8): 1410–1411.
Zhai Y, Zhang B, Bai F, et al., 2022, Analysis of Clinical Characteristics of Moyamoya Disease in Southwest Henan. Journal of Practical Cardio-Cerebro-Pulmonary Vascular Diseases, 30(12): 110–114.
Wang C, Li H, Li K, et al., 2022, Establishment and Validation of a Nomogram Model of Cerebral Infarction After Moyamoya Disease. Stroke and Neurological Diseases, 29(4): 333–337.
Hayashi T, Kimiwada T, Karibe H, et al., 2021, Preoperative Risks of Cerebral Infarction in Pediatric Moyamoya Disease. Stroke, 11(7): 137–139.
Zhu Y, Zhang J, 2021, Clinical Research on Evidence-Based Nursing on Postoperative Complications of Moyamoya Disease Combined with Revascularization and Improvement of Patients’ Quality of Life. Clinical Research, 29(10): 165–166.
Doron O, Langer D, Nossek E, 2023, 481 Troubleshooting the Bypass: Intraoperative Management of Initially Failed Anastomosis in Cerebral Extracranial – Intracranial Direct Revascularization Surgery. Neurosurgery, 26(12): 1127–1130.
Zhai X, Mao L, Wang H, 2020, Predictors of Reversible Neurological Dysfunction After Moyamoya Disease Combined with Revascularization. Journal of Clinical Neurology, 33(2): 123–127.
Wang L, Zhou K, Wang S, et al., 2022, Analysis of Risk Factors for Severe Complications After Moyamoya Disease Combined with Revascularization. Journal of Wuhan University (Medical Science), 43(1): 93–96+101.
Gao S, 2008, Diagnostic Criteria for Moyamoya Disease. Chinese Journal of Stroke, 3(7): 500–501.
Peng H, 2022, Value analysis of magnetic resonance multi-b-value diffusion-weighted imaging (DWI) combined with spectral imaging (MRS) in the diagnosis of prostate cancer [J]. Primary Medical Forum, 26(29): 61–63.
Zhang C, Zhang L, Mao L, 2019, Evaluation of Postoperative Complications and Influencing Factors of Vascular Reconstruction in Moyamoya Disease. Contemporary Medicine, 25(34): 96–98.
Hirano Y, Miyawaki S, Imai H, et al., 2020, Association Between the Onset Pattern of Adult Moyamoya Disease and Risk Factors for Stroke. Stroke, 51(10): 477–479.
Li K, Li H, Yang B, et al., 2022, Correlation Between Posterior Circulation Classification of Moyamoya Disease and Surgical Efficacy and Perfusion. Chinese Journal of Practical Nervous Diseases, 25(3): 265–269.
Li Y, Liu X, Zhang Z, et al., 2022, Analysis of the Effect of Different Surgical Methods in the Treatment of Adult Subarachnoid Hemorrhage Moyamoya Disease. Chinese Journal of Practical Diagnosis and Therapy, 36(7): 724–728.
Masahito K, Miki F, Ryosuke T, et al., 2020, Pre-operative Higher Hematocrit and Lower Total Protein Levels are Independent Risk Factors for Cerebral Hyperperfusion Syndrome After Superficial Temporal Artery–Middle Cerebral Artery Anastomosis with Pial Synangiosis in Adult Moyamoya Disease Patients: Case-Control Study. Neurosurgical Review, 44(17): 457–479.
Liu K, Sun T, Han M, et al., 2022, Analysis of Risk Factors for Complications After Cerebrovascular Bypass Surgery in Ischemic Moyamoya Disease. Chinese Journal of Modern Neurological Diseases, 22(5): 380–385.
Unda S, Antoniazzi M, Miller R, et al., 2021, Moyamoya Disease and Syndrome: A National Inpatient Study of Ischemic Stroke Predictors. Journal of Stroke and Cerebrovascular Diseases, 30(9): 767–771.
Liang H, Zhao L, Gao T, et al., 2021, Analysis of Influencing Factors of Postoperative Complications in Adult Moyamoya Disease Combined with Cerebrovascular Reconstruction. Chinese Journal of Neurosurgery, 37(3): 245–249.
Lukshin V, Shulgina A, Usachev D, et al., 2021, Ischemic Complications Following Surgical Treatment of Moyamoya Disease: Risk Factors and Prevention. Zhurnal Voprosy Neirokhirurgii Imeni Burdenko, 85(6): 1332–1337.
Yang S, Li X, Jin L, et al., 2022, Seizure Characteristics and Risk Factors Analysis of Adult Moyamoya Disease Combined with Revascularization. Chinese Journal of Modern Neurological Diseases, 22(7): 586–591.
Nakamizo A, Amano T, Matsuo S, et al., 2022, Five-Year Changes in Cognitive Function and Their Predictor in Adult Moyamoya Disease. World Neurosurgery, 16 (5): 1477–1450.
Li D, Zhou G, Zhou W, et al., 2019, Analysis of Changes in TCD and mRS Scores After Vascular Anastomosis in Patients with Moyamoya Disease. Chinese Journal of Experimental Diagnostics, 23(1): 60–62.
Feng Z, Chang Z, Chu X, et al., 2020, Risk Factors Analysis of Hemodynamic Instability After Revascularization for Takayasu Arteritis. Chinese Journal of General Surgery, 35(12): 956–960.