Outcomes of bypass surgery in asymptomatic moyamoya angiopathy: A multicenter study with propensity-score weighting.
Publication/Presentation Date
8-30-2025
Abstract
INTRODUCTION: Asymptomatic moyamoya angiopathy (MMA) is increasingly detected through noninvasive imaging; however, its optimal management remains controversial. This multicenter retrospective cohort study compared outcomes in asymptomatic versus symptomatic MMA patients undergoing surgical revascularization.
PATIENTS AND METHODS: A total of 475 patients treated with bypass surgery across multiple academic centers were included, with 56 (11.8%) classified as asymptomatic and 419 (88.2%) as symptomatic. Baseline demographics, surgical characteristics, and outcomes-including perioperative stroke, intraoperative complications, and follow-up stroke events-were collected. Asymptomatic MMA was defined as the absence of any prior ischemic or hemorrhagic stroke, seizures, or other neurological symptoms at the time of diagnosis. Both unadjusted analyses and propensity score weighting using inverse probability of treatment weighting (IPTW) were performed to adjust for potential confounders.
RESULTS: In the unadjusted analysis, asymptomatic patients had significantly lower rates of all perioperative strokes (1.7% vs 11.4%;
CONCLUSION: Bypass surgery in selected asymptomatic MMA patients is associated with reduced intraoperative complications, and fewer follow-up stroke rates. These findings support the careful consideration of surgical intervention in asymptomatic patients, emphasizing the importance of patient selection for optimal outcomes.
First Page
23969873251365504
Last Page
23969873251365504
ISSN
2396-9881
Published In/Presented At
Musmar, B., Abdalrazeq, H., Roy, J. M., Adeeb, N., Atallah, E., El Naamani, K., Chen, C. J., Jabre, R., Saad, H., Grossberg, J. A., Dmytriw, A. A., Patel, A. B., Khorasanizadeh, M., Ogilvy, C. S., Thomas, A. J., Monteiro, A., Siddiqui, A., Cortez, G. M., Hanel, R. A., Porto, G., … Jabbour, P. (2025). Outcomes of bypass surgery in asymptomatic moyamoya angiopathy: A multicenter study with propensity-score weighting. European stroke journal, 23969873251365504. Advance online publication. https://doi.org/10.1177/23969873251365504
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
40884244
Department(s)
Administration and Leadership
Document Type
Article