We have located links that may give you full text access.
Preoperative evaluation of moyamoya spontaneous anastomosis of combined revascularization donor vessels in adults by duplex ultrasonography.
British Journal of Neurosurgery 2018 August
OBJECTIVE: To evaluate the preoperative diagnostic value of duplex ultrasonography in moyamoya spontaneous anastomosis of combined revascularization donor vessels in adults.
METHODS: A total of 99 preoperative adult patients who underwent superficial temporal artery-to-middle cerebral artery (STA-MCA) anastomosis were retrospectively analyzed. Each side of the cerebral hemisphere was examined as a separate procedure. A total of 198 cerebral hemispheres were divided into three groups: a collateral, non-collateral, and control group based on digital subtraction angiography (DSA). Hemodynamic parameters, including peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) were analyzed.
RESULTS: There were only four of cases (5%, 4/198) of STA spontaneous anastomosis, whereas those of maxillary artery (MA) anastomosis were 44 (23.7%, 44/186). Compared with the control group, MA PSV and EDV of the collateral group increased significantly, while RI decreased significantly (p < .05). The area under the curve (AUC) of MA RI was 0.654. As a predictor of MA spontaneous anastomosis, duplex ultrasonography had high specificity but poor sensitivity. In collateral group, PSV and EDV detected two weeks post-surgery were significantly higher than those detected pre-operatively (PSV: p = .018, EDV: p = .025). By contrast, there were no significant difference of the PSV and EDV detected six months post-surgery compared with pre-operation (PSV: p = .450, EDV: p = .099). Additionally, MA RI in two weeks after the surgery was comparable with preoperative values.
CONCLUSIONS: Duplex ultrasonography could be applied to evaluate the adult moyamoya spontaneous anastomoses of MA preoperatively. Despite its poor sensitivity, this diagnostic modality is still reliable and specific. STA-MCA anastomosis combined with EDMS did not affect MA pre-operative spontaneous anastomosis.
METHODS: A total of 99 preoperative adult patients who underwent superficial temporal artery-to-middle cerebral artery (STA-MCA) anastomosis were retrospectively analyzed. Each side of the cerebral hemisphere was examined as a separate procedure. A total of 198 cerebral hemispheres were divided into three groups: a collateral, non-collateral, and control group based on digital subtraction angiography (DSA). Hemodynamic parameters, including peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) were analyzed.
RESULTS: There were only four of cases (5%, 4/198) of STA spontaneous anastomosis, whereas those of maxillary artery (MA) anastomosis were 44 (23.7%, 44/186). Compared with the control group, MA PSV and EDV of the collateral group increased significantly, while RI decreased significantly (p < .05). The area under the curve (AUC) of MA RI was 0.654. As a predictor of MA spontaneous anastomosis, duplex ultrasonography had high specificity but poor sensitivity. In collateral group, PSV and EDV detected two weeks post-surgery were significantly higher than those detected pre-operatively (PSV: p = .018, EDV: p = .025). By contrast, there were no significant difference of the PSV and EDV detected six months post-surgery compared with pre-operation (PSV: p = .450, EDV: p = .099). Additionally, MA RI in two weeks after the surgery was comparable with preoperative values.
CONCLUSIONS: Duplex ultrasonography could be applied to evaluate the adult moyamoya spontaneous anastomoses of MA preoperatively. Despite its poor sensitivity, this diagnostic modality is still reliable and specific. STA-MCA anastomosis combined with EDMS did not affect MA pre-operative spontaneous anastomosis.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app