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Adolescents with moyamoya disease: clinical features, surgical treatment and long-term outcomes

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Abstract

Background

This study aimed to elucidate the clinical features, surgical treatment and long-term outcomes of adolescent patients with moyamoya disease.

Methods

We reviewed consecutive patients with moyamoya vasculopathy who were admitted to our hospital from 2009 to 2015 to identify adolescent patients with moyamoya disease. Clinical features, surgical treatment and long-term outcomes were analyzed. Follow-up was performed by face-to-face or structured telephone interviews. Outcome measures were future stroke events. We performed univariate and multivariate time-to-event analyses to identify risk factors associated with future stroke events.

Results

A total of 95 adolescent patients with moyamoya disease (age at onset, 13.1 ± 2.3 years) were included in this study. During follow-up, 12 patients (12.6%) had stroke events. We found that the patients who underwent direct/combined bypass had a significantly lower risk of future strokes [hazard ratio (HR), 0.16; 95% confidence interval (CI), 0.03–0.74; P = 0.019] compared to patients who underwent indirect bypass.

Conclusions

Our results demonstrate that direct/combined bypass can be more effective in preventing future strokes than indirect bypass in adolescent patients with moyamoya disease.

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Acknowledgements

This study is supported by the “13th Five-Year Plan” National Science and Technology Supporting Plan (2015BAI12B04), the National Natural Science Foundation of China (81371292) and the Beijing Municipal Administration of Hospitals’ Mission Plan (SML20150501).

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Authors and Affiliations

  1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantanxili, Dongcheng District, Beijing, People’s Republic of China, 100050

    Meng Zhao, Dong Zhang, Shuo Wang, Yan Zhang, Rong Wang, Xiaofeng Deng, Faliang Gao & Jizong Zhao

  2. China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China

    Meng Zhao, Dong Zhang, Shuo Wang, Yan Zhang, Rong Wang, Xiaofeng Deng, Faliang Gao & Jizong Zhao

  3. Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People’s Republic of China

    Meng Zhao, Dong Zhang, Shuo Wang, Yan Zhang, Rong Wang, Xiaofeng Deng, Faliang Gao & Jizong Zhao

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  1. Meng Zhao
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  3. Shuo Wang
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Correspondence to Jizong Zhao.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Beijing Tiantan Hospital Research Ethics Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants (parent or guardian) included in the study.

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Zhao, M., Zhang, D., Wang, S. et al. Adolescents with moyamoya disease: clinical features, surgical treatment and long-term outcomes. Acta Neurochir 159, 2071–2080 (2017). https://doi.org/10.1007/s00701-017-3286-x

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  • DOI: https://doi.org/10.1007/s00701-017-3286-x

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