Difference in Cerebral Circulation Time between Subtypes of Moyamoya Disease and Moyamoya Syndrome

Kang, Kaijiang; Lu, Jingjing; Zhang, Dong; Li, Youxiang; Wang, Dandan; Liu, Peng; Li, Bohong; Ju, Yang; Wang, Wenjuan

doi:10.1038/s41598-017-02588-1

Cited by 4 publications

(4 citation statements)

References 37 publications

(41 reference statements)

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“…This suggests that an increased cerebral circulation time in multiple patients with sclerosis corresponds to microvascular dysfunction [ 20 ]. Another study has revealed differences in cerebral circulation time between patients with hemorrhagic and non-hemorrhagic moyamoya disease [ 21 ]. Cerebral circulation time of the contrast may vary depending on the degree of cerebral perfusion in the brain parenchyma.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a silicone vascular phantom replicating real arterial contrast filling dynamics on cerebral angiography: An in-vitro pilot study

Lee¹,

Sheen

Yoon

et al. 2023

PLoS ONE

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Some cerebral arterial silicone phantoms have been used in preclinical evaluations. However, typical silicone-based phantoms are limited in their capacity to reproduce real contrast filling dynamics of the human cerebral artery. This study aimed to develop a cerebral arterial silicone phantom to analyze the feasibility of real contrast filling dynamics. The fluid circulation phantom system consisted of a cerebral arterial silicone phantom without or with additional devices, a pump, an injection system, a pressure-monitoring system, a constant-temperature bath, and a venous drainage container. Vascular resistance was reproduced with a plastic cistern only or a plastic cistern filled with a sponge pad. Three phantom groups were constructed as follows: a) the cerebral arterial silicone phantom used as the control group (type A), b) phantom with the incorporated plastic cistern (type B), and c) phantom with the incorporated plastic cistern filled with a sponge pad (type C). The contrast concentration–time curve patterns of the three groups obtained from digital subtraction angiography (DSA) were compared. Consequently, the DSA pattern of the type C phantom was the most similar to that obtained from the control group as the reference data, which showed the broadest full-width-at-half-maximum and the area under the curve values and the highest maximum contrast concentration. In conclusion, we could emulate the arterial contrast filling dynamics of clinical cerebral angiography by applying a small cistern filled with a sponge pad at the drainage side of the phantom.

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Section: Discussionmentioning

confidence: 99%

Feasibility of a silicone vascular phantom replicating real arterial contrast filling dynamics on cerebral angiography: An in-vitro pilot study

Lee¹,

Sheen

Yoon

et al. 2023

PLoS ONE

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“…Hemorrhagic stroke is one of the main factors leading to worse prognosis, and occurs mainly owing to the rupture of abnormally contribute to decreasing the risk of rebleeding in patients with hemorrhagic MMD (13,17,18,21). However, with the establishment of artificial collateral vessels and the regression of original collateral vessels, how the cerebral hemodynamics changes in hemorrhagic MMD after surgical revascularization is still unclear.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Hemodynamic Changes After Revascularization in Patients With Hemorrhagic Moyamoya Disease

Kang

et al. 2020

Front. Neurol.

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Objective: To explore the cerebral hemodynamic changes after revascularization in patients with hemorrhagic moyamoya disease (MMD). Materials and Methods: We retrospectively included 57 hemorrhagic MMD patients in a high-volume stroke center from January 2016 to December 2018. All subjects were evaluated with whole-brain CT perfusion (CTP) before and after surgical revascularization. Absolute and relative CTP values in the regions of cortical middle cerebral artery territory (CMT) and deep brain area (DBA) of hemorrhagic hemispheres were measured. Differences between pre-and post-operative CTP values were assessed comprehensively. The patients were categorized into subgroups based on revascularization subtypes and postoperative CTP intervals. Results: The relative cerebral blood volume (rCBV) in DBA and CMT significantly reduced in postoperative CTP (P < 0.05). The median and interquartile range of the proportion of rCBV decrease (rCBVc%) were 7.2% (2.3-13.2%). The rCBV reduction retained statistical significant in patients who received subtypes of revascularization, and in patients with variable intervals of follow-up (P < 0.05). There was no significant difference of rCBVc% between patients who received different revascularization and among patients with different postoperative CTP intervals (P > 0.05). The relative mean transit time (rMTT) and relative time to peak (rTTP) also showed downward trends, but without retainable statistical significance in stratified analysis. There was no significant change in relative cerebral blood flow (rCBF) (P > 0.05). Conclusion: In patients with hemorrhagic MMD, the CBV appeared to decrease and be relatively stable in the chronic phase after revascularization, with varying degrees of MTT and TTP shortening. However, there was no significant change in CBF.

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“…It is suggested that intracranial hemorrhage occurs mainly owing to the rupture of abnormal moyamoya vessels, dilated collateral vessels, and complicated aneurysms (13)(14)(15). Revascularization surgery was supposed to decrease the intravascular pressure load of original collaterals in internal carotid artery (ICA) system and alleviate the dilation of collateral vessels or complicated aneurysms, which may contribute to decrease the risk of rebleeding in patients with hemorrhagic MMD (13,17,18,(26)(27)(28). However, there has been much controversy with respect to the most appropriate surgical method and outcome of hemorrhagic MMD.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Radiological Outcomes After Revascularization of Hemorrhagic Moyamoya Disease

Kang

et al. 2020

Front. Neurol.

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Objective: To evaluate clinical and radiological outcomes after revascularization of hemorrhagic moyamoya disease (MMD). Materials and Methods:We retrospectively collected patients with hemorrhagic MMD who received revascularization from January 2011 to June 2018 at a high-volume stroke center. Rebleeding, ischemic stroke, modified Rankin Scale (mRS) and death after revascularization were used to evaluate long-term clinical outcome. Poor neurological outcome was defined as a mRS>2. The changes of original and revascularization collaterals were used to evaluate radiological outcome. The clinical and radiological outcomes between patients with different surgical revascularization were compared.Results: A total of 312 patients (319 hemispheres) were recruited, including 133 hemispheres (41.7%) with indirect revascularization and 186 hemispheres (58.3%) with direct revascularization. In 308 hemispheres with clinical follow-up data, Postoperative rebleeding, ischemic stroke, poor neurological outcome and death occurred in 13.0% (40/308), 2.6% (8/308), 12.0% (37/308), and 6.2% (19/308) of the hemispheres, respectively. The rates of postoperative rebleeding (8.5 vs. 19.1%, P = 0.006) and poor neurological outcome (8.5 vs. 16.8%, P = 0.026) were lower in hemispheres with direct revascularization than those with indirect revascularization. However, there was no statistically significant difference in the rates of postoperative ischemic stroke (1.1 vs. 4.6%, P = 0.129) and death (4.5 vs. 8.4%, P = 0.162) between the two groups. Multivariate logistic regression analysis indicated that the risk of postoperative rebleeding was higher in those with untreated aneurysms, repetitive bleeding episodes, normal perfusion status, and indirect revascularization (P < 0.05). In 78 hemispheres with radiological follow-up data, the regression of moyamoya vessels, anterior choroidal artery (AchA), posterior communicating artery (PcomA) and aneurysms were present in 44.9, 47.4, 25.6, and 11.5% of the hemispheres, respectively. The regression of original collaterals and establishment of revascularization collaterals were more significant in hemispheres with direct revascularization than those with indirect revascularization (P < 0.05). Conclusion:Direct revascularization may be superior to indirect revascularization for prevention of rebleeding and poor neurological outcome in adults with hemorrhagic MMD. The risk of postoperative rebleeding was higher in those with untreated aneurysms, Kang et al.Surgical Outcomes of Hemorrhagic Moyamoya Disease repetitive bleeding episodes, normal perfusion status, and indirect revascularization. The regression of original collaterals and establishment of revascularization collaterals after revascularization were more significant in hemispheres with direct revascularization than those with indirect revascularization.

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Difference in Cerebral Circulation Time between Subtypes of Moyamoya Disease and Moyamoya Syndrome

Cited by 4 publications

References 37 publications

Feasibility of a silicone vascular phantom replicating real arterial contrast filling dynamics on cerebral angiography: An in-vitro pilot study

Feasibility of a silicone vascular phantom replicating real arterial contrast filling dynamics on cerebral angiography: An in-vitro pilot study

Cerebral Hemodynamic Changes After Revascularization in Patients With Hemorrhagic Moyamoya Disease

Clinical and Radiological Outcomes After Revascularization of Hemorrhagic Moyamoya Disease

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