Predictors of perioperative stroke in patients with Ischemic-type moyamoya disease treated with surgical revascularization: A retrospective multicenter study.
Publication/Presentation Date
5-1-2025
Abstract
INTRODUCTION: Moyamoya disease (MMD) is a chronic cerebrovascular disorder characterized by progressive stenosis or occlusion of the internal carotid arteries and the development of collateral moyamoya vessels. Surgical revascularization is commonly used to prevent future ischemic events in ischemic-type MMD, but there remains a high rate of stroke perioperatively. This study aims to analyze the predictive factors for perioperative stroke in patients with ischemic-type MMD undergoing surgical revascularization using a large multicenter database.
METHODS: We conducted a multicenter retrospective study in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. This study included patients with ischemic-type MMD who underwent surgical revascularization across 13 academic institutions in North America. Data were collected and analyzed on a per-hemisphere basis, covering patient demographics, disease characteristics, procedural details, and outcomes. Statistical analyses were performed using Stata (V.17.0), comparing baseline characteristics, and using univariable and multivariable logistic regression to identify predictors of perioperative stroke.
RESULTS: A total of 301 patients with ischemic-type MMD underwent surgical revascularization, with 34 patients (11.3 %) experiencing perioperative stroke. Patients who experienced perioperative stroke had a mean age of 43.6 years (SD 14.0) compared to 40.0 years (SD 13.9) in those without perioperative stroke (P = 0.16). Hypertension was significantly more prevalent in the perioperative stroke group (73.5 % vs. 47.9 %, P = 0.005). Current smoking was also more common in the perioperative stroke group (55.8 % vs. 38.2 %, P = 0.04). Multivariate logistic regression identified hypertension (OR 2.32, 95 % CI 1.01 to 5.37, P = 0.04) and current smoking (OR 2.28, 95 % CI 1.04 to 4.97, P = 0.03) as significant independent predictors of perioperative stroke.
CONCLUSION: Hypertension and smoking were significant predictors of perioperative stroke in patients with ischemic-type MMD undergoing surgical revascularization. These findings emphasize the importance of managing risk factors in ischemic-type MMD. Further prospective studies are needed to validate these findings.
Volume
34
Issue
5
First Page
108277
Last Page
108277
ISSN
1532-8511
Published In/Presented At
Musmar, B., Roy, J. M., Abdalrazeq, H., Atallah, E., Naamani, K. E., 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., Spiotta, A. M., … Jabbour, P. (2025). Predictors of perioperative stroke in patients with Ischemic-type moyamoya disease treated with surgical revascularization: A retrospective multicenter study. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 34(5), 108277. https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108277
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
40057254
Department(s)
Administration and Leadership
Document Type
Article