Intracranial stent placement in a patient with moyamoya disease

Santirso, Daniel; Oliva, P. De La; González, Manuel; Murias, Eduardo; Vega, Pedro; Gil, Alberto; Calleja, Sergio

doi:10.1007/s00415-011-6105-y

Cited by 9 publications

(12 citation statements)

References 5 publications

(5 reference statements)

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“…This review illustrates the remarkable lack of such studies evaluating endovascular approaches, a topic that is still reportable in a case report format [3,4,21]. Although the known success of surgical revascularization may limit consideration of endovascular approaches, the relative potential technical ease of endovascular therapies may have catalyzed an espousal of these approaches if they were efficacious.…”

Section: Discussionmentioning

confidence: 92%

“…We collected results across a total of seven reports [3,4,13,14,18,20,21], adding our own case. Two of these were North American case series, the remainder single case reports.…”

Section: Resultsmentioning

confidence: 99%

“…Twelve patients underwent 17 angioplasty procedures (Table 1) while 9 patients underwent 11 stenting procedures ( Table 2). Of note, 10 of 11 stents deployed were Wingspan [3,13,18,21], while the other was an AVE INX3 coronary stent [14]. There was no statistically significant difference between the angioplasty alone and stenting groups in the rate of post-procedural hemorrhage (6 % for angioplasty vs 9 % for stenting, p=1.0), angiographic recurrence (66 % for angioplasty vs 70 % for stenting, p=1.0), or clinical recurrence (54 % for angioplasty vs 60 % for stenting, p=1.0).…”

Section: Resultsmentioning

confidence: 99%

“…Rather, this specific phenomenon should be evaluated separately. Currently, there is only a paucity of reports detailing endovascular approaches to moyamoya [3,4,13,14,18,20,21]. It is important to address whether this is merely a result of a bias for proven surgical revascularization methods or whether it is also a result of a lack of efficacy of these approaches.…”

Section: Introductionmentioning

confidence: 95%

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Endovascular treatment of symptomatic moyamoya

2014

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Moyamoya is a rare though important source of neurological morbidity as a result of both ischemic and hemorrhagic sequelae. Although a litany of series detailing the endovascular management of cerebral ischemia is present in the literature, only a paucity of such reports exists for moyamoya. A systematic review of the literature was performed for patients with moyamoya managed with endovascular techniques in addition to the contribution of an additional case managed at our institution. We evaluated treatment approach (angioplasty and/or stent), complications, and both angiographic and clinical outcomes at last follow-up. Results from a total of 28 endovascular procedures were collected (11 stenting, 17 angioplasty alone). Procedural success, defined as a lack of both angiographic and clinical recurrence at follow-up, was achieved after seven procedures (25 %). This rate did not significantly differ between disease type (moyamoya disease vs moyamoya syndrome, p = 1.0) and treatment approach (angioplasty alone vs stenting, p = 1.0). The overall monthly angiographic and clinical recurrence rates were 9.3 and 8.0 %, respectively. Clinically devastating intracerebral hemorrhage was seen after two procedures (7 %), and in an additional three procedures, the treated vessel could not be effectively dilated (11 %). There is no evidence that angioplasty or stenting improves the natural history of moyamoya. Both are associated with significant rates of early angiographic and/or clinical recurrence of symptoms. Taken with the risk of procedural complications, the current limited data should advise against attempted endovascular treatment of moyamoya.

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Section: Discussionmentioning

confidence: 92%

“…We collected results across a total of seven reports [3,4,13,14,18,20,21], adding our own case. Two of these were North American case series, the remainder single case reports.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

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Endovascular treatment of symptomatic moyamoya

2014

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“…16 In contrast to the poor course associated with medical treatment, surgically treated patients with moyamoya angiopathy in general fare better compared with the natural history of the disease. [17][18][19][20][21] Direct anastomotic procedures use the STA, occipital artery, or middle meningeal artery as donor vessels and the MCA, anterior cerebral artery, or posterior cerebral artery as recipient vessels. Indirect revascularization procedures rely on the angiogenic potential of donor tissue such as temporalis muscle, dura, occipital artery, middle meningeal artery, STA, galea, pericranium, and omentum placed on the ischemic brain.…”

Section: Discussionmentioning

confidence: 99%