One sided bypass for bilateral Moyamoya disease, a case report and review of the literatures

Li, Xuhui; Zhao, Ninghui; Yang, Zichu

doi:10.1016/j.ijscr.2016.03.015

Cited by 2 publications

(2 citation statements)

References 11 publications

(16 reference statements)

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Section: Resultsmentioning

confidence: 99%

“…Alternatively, patients may present with a delayed non-ischemic cerebral enhancing lesion, as described by Shotar et al 30 Worth noting that however, some neurovascular conditions are better treated with open surgical procedure rather than using endovascular approaches, for example Moyamoya disease. 71 Respiratory manifestations. Adverse effects on the respiratory system were minor and seen only in 7 patients, representing 19.4% of the patient population.…”

Section: Adverse Events and Postoperative Complications Relating To N...mentioning

confidence: 99%

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Nickel-related hypersensitivity reactions following endovascular interventions: A review of current evidence

Tjen,

Yang

2023

Science Progress

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Introduction: Nickel is a principal alloying agent in the production of vascular endoprostheses, despite persisting as the most habitually identified allergen. Variable nickel-related hypersensitivity manifestations following endovascular intervention were reported, challenging established paradigms in treatment and accuracy of prognostic assessments. The objective of this review is to critically evaluate current metrics to maximise patient-related outcomes. Methods: A literature review was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 statement. Patients indicative of nickel hypersensitivity reaction following endovascular intervention were discerned. A positive reaction was defined by patch testing, histological analysis, or anamnesis indicative of nickel hypersensitivity. Morphology of implicating prostheses, adverse events and postoperative complications, clinical course, diagnostic and therapeutic strategies alongside patient prognosis were recorded. Results: Nickel-related hypersensitivity reactions following endovascular repair were identified in 36 patients with a median age of 44.5 years. 20 patients received nitinol-containing intervention. 28 (77.8%) patients are female. Multi-organ adverse reactions occurred in 21 (58.3%) patients with variable latency. 14 (38.9%) patients were presented with neurological adverse reactions manifesting mainly as unilateral hemiparesis. Dermatological reactions implicated 16 (44.4%) patients. Miscellaneous manifestations include suicidal ideation. 13 (36.1%) patients displayed previous metal intolerance and 32 (88.9%) patients had positive patch testing for nickel. Histological analysis of lesions and prostheses indicated lymphocytic infiltration. 5 (13.9%) patients experienced device-specific reactions as in-stent restenosis or auxiliary distal vessel stenosis. 11 (30.1%) patients received solely medical therapy and 5 (13.9%) patients received solely surgical therapy. 19 (52.7%) patients underwent both medical (oral corticosteroid) and surgical therapy (device retrieval). 26 (77.1%) patients achieved symptomatic cessation, 6 (16.7%) patients exhibited symptomatic persistence and 0 patients died. Conclusion: Prophylactic pre-assessment for a history of metal allergy and consideration of prostheses alternatives is recommended to minimise reaction risk and severity. Despite nickel's predominant usage, information paucity urges additional studies to emphasise its implications and maximise patient outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Adverse Events and Postoperative Complications Relating To N...mentioning

confidence: 99%

Nickel-related hypersensitivity reactions following endovascular interventions: A review of current evidence

Tjen,

Yang

2023

Science Progress

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Case Report: A rare presentation of rapidly progressive moyamoya disease refractory to unilateral surgical revascularization

Leach,

Margam,

Gustin

et al. 2024

Front. Surg.

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Moyamoya disease (MMD) is a chronic, occlusive cerebrovasculopathy typified by progressive steno-occlusive disease of the intracranial internal carotid arteries (ICAs) and their proximal branches. Moyamoya syndrome (MMS) categorizes patients with characteristic MMD plus associated conditions. As such, the most usual presentations are those that occur with cerebral ischemia, specifically transient ischemic attack, acute ischemic stroke, and seizures. Hemorrhagic stroke, headaches, and migraines can also occur secondary to the compensatory growth of fragile collateral vessels propagated by chronic cerebral ischemia. While the pathophysiology of MMD is unknown, there remain numerous clinical associations including radiation therapy to the brain, inherited genetic syndromes, hematologic disorders, and autoimmune conditions. We describe the case of a 31-year-old woman who presented with recurrent ischemic cerebral infarcts secondary to rapidly progressive, bilateral MMD despite undergoing early unilateral surgical revascularization with direct arterial bypass. She had numerous metabolic conditions and rapidly decompensated, ultimately passing away despite intensive and aggressive interventions. The present case highlights that progression of moyamoya disease to bilateral involvement can occur very rapidly, within a mere 6 weeks, a phenomenon which has not been documented in the literature to our knowledge.

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One sided bypass for bilateral Moyamoya disease, a case report and review of the literatures

Cited by 2 publications

References 11 publications

Nickel-related hypersensitivity reactions following endovascular interventions: A review of current evidence

Nickel-related hypersensitivity reactions following endovascular interventions: A review of current evidence

Case Report: A rare presentation of rapidly progressive moyamoya disease refractory to unilateral surgical revascularization

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