Introduction
Methods
Data collection
Statistical analysis
Revascularization procedure
Results
Demographical analysis
Patient population | Total cohort | SCA | Trisomy 21 | NF1 | MMD | p value |
---|---|---|---|---|---|---|
N (patients) | 22 | 6 | 5 | 5 | 6 | |
N (hemispheres) | 30 | 11 | 5 | 5 | 9 | |
Gender (% male) | 9 (40.9%) | 5 (83.3%) | 1 (20.0%) | 1 (20.0%) | 2 (33.3%%) | 0.09 |
Age at presentation | 7.5 (5.7) | 5.3 (2.8) | 12.7 (7.3) | 5.6 (5.3) | 6.9 (5.0) | 0.38 |
Pre-op mRS | 1.05 (1.59) | 1.67 (1.63) | 0.60 (1.34) | 0.00 (0.00) | 1.67 (2.07) | 0.15 |
Presenting symptoms | ||||||
Stroke | 14 (63.6%) | 6 (100.0%) | 3 (60.0%) | 0 (0%) | 5 (83.3%) | < 0.01* |
TIA | 4 (18.2%) | 1 (16.7%) | 0 (0%) | 1 (20.0%) | 2 (33.3%) | 0.56 |
Seizure | 4 (18.2%) | 0 (0%) | 3 (60.0%) | 0 (0%) | 1 (16.7%) | 0.04 |
Radiographic findings | ||||||
Radiographic strokes | 15 (68.2%) | 6 (100.0%) | 4 (80.0%) | 0 (0.0%) | 5 (83.3%) | < 0.01* |
Ivy sign | 14 (63.6%) | 4 (66.7%) | 3 (60.0%) | 4 (80.0%) | 3 (50.0%) | 0.77 |
Suzuki score | 3.83 (1.07) | 3.50 (1.43) | 4.20 (0.84) | 4.00 (0.71) | 3.89 (0.93) | 0.64 |
Total cohort | SCA | Trisomy 21 | NF1 | MMD | p value | |
---|---|---|---|---|---|---|
Intraoperative data | ||||||
Indirect bypass | 29 (96.7%) | 11 (100.0%) | 4 (80.0%) | 5 (100.0%) | 9 (100.0%) | |
EBL (mL) | 117.5 (76.1) | 121.8 (73.1) | 102.5 (70.9) | 106.0 (111.5) | 125.3 (72.2) | 0.74 |
EEG changes | 3 (10.3%) | 3 (27.3%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0.14 |
Intraop complications | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | n.s |
Peri-operative ischemic events | ||||||
Stroke | 1 (3.3%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 1 (11.1%) | 0.49 |
TIA | 6 (20.0%) | 2 (18.2%) | 0 (0.0%) | 0 (0.0%) | 4 (44.4%) | 0.12 |
Death | 0 | 0 | 0 | 0 | 0 |
Perioperative findings
Unilateral vs. bilateral disease
Unilateral disease | Bilateral disease | p value | |
---|---|---|---|
Demographics | |||
N (patients) | 15 (68.2%) | 7 (31.8%) | |
N (hemispheres) | 15 (50%) | 15 (50%) | |
Gender (% male) | 4 (26.7%) | 5 (71.4%) | 0.07 |
Age | 7.5 (6.2) | 7.4 (4.7) | 0.55 |
Pre-op mRS | 0.87 (1.51) | 1.43 (1.81) | 0.49 |
SCA | 2 (13.3%) | 4 (57.1%) | 0.05 |
Trisomy 21 | 5 (33.3%) | 0 (0.0%) | 0.14 |
NF1 | 5 (33.3%) | 0 (0.0%) | 0.14 |
MMD (idiopathic) | 3 (20%) | 3 (42.9%) | 0.33 |
Presenting stroke | 7 (46.7%) | 7 (100.0%) | 0.02* |
Radiographic stroke | 8 (53.3%) | 7 (100.0%) | 0.05 |
Ivy sign | 10 (66.7%) | 4 (57.1%) | 1.00 |
Suzuki score | 3.93 (0.88) | 3.71 (1.27) | 0.64 |
Peri-operative ischemic events | |||
Stroke | 0 (0.0%) | 1 (6.7%) | 1.00 |
TIA | 1 (6.7%) | 5 (33.3%) | 0.17 |
Post-operative ischemic events | |||
Strokea | 3 (13.3%) | 3 (42.9%) | 0.27 |
TIA | 0 (0.0%) | 0 (0.0%) | n.s. |
Outcomes | |||
Clinical F/up length | 3.0 (2.3) | 4.7 (3.5) | 0.30 |
Radiographic F/up length | 3.4 (2.2) | 4.9 (3.3) | 0.37 |
mRS | 0.73 (1.33) | 1.29 (1.60) | 0.63 |
Matsushima A | 81.80% | 100.0% | 0.16 |
Index surgery | Surgery for second side | p value | |
---|---|---|---|
Number of hemispheres | 22 | 8 | |
Intraoperative data | |||
EBL (mL) | 116.9 (73.6) | 119.1 (87.8) | 0.96 |
EEG changes | 1 (4.8%) | 2 (25.0%) | 0.18 |
Intraop complications | 0 (0.0%) | 0 (0.0%) | n.s |
Peri-operative ischemic events | |||
Stroke | 1 (4.5%) | 0 (0.0%) | 1.00 |
TIA | 2 (9.1%) | 4 (50.0%) | 0.03* |
Surgical outcomes
Total cohort | SCA | Trisomy 21 | NF1 | MMD | p value | |
---|---|---|---|---|---|---|
Clinical follow up | ||||||
Length | 3.5 (2.8) | 5.2 (3.1) | 3.5 (3.0) | 2.9 (2.6) | 2.3 (2.2) | 0.27 |
mRS at follow-up | 0.91 (1.41) | 1.33 (1.37) | 0.60 (0.89) | 0.00 (0.00) | 1.50 (2.07) | 0.18 |
Mortality | 1 (4.5%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 1 (16.7%) | 0.43 |
Radiographic follow-up | ||||||
MRI F/up length | 3.9 (2.6) | 5.1 (2.9) | 4.0 (3.1) | 3.7 (2.2) | 2.6 (2.3) | 0.44 |
Angio F/up length | 1.5 (0.7) | 2.0 (0.9) | 1.3 (0.2) | 1.0 (0.0) | 1.1 (0.2) | 0.03* |
Matsushima A | 19 (90.5%) | 6 (75%) | 4 (100.0%) | 3 (100.0%) | 6 (100.0%) | 0.31 |
Post-operative ischemic events | ||||||
Strokea | 5 (22.3%) | 2 (33.3%) | 1 (20.0%) | 0 (0.0%) | 2 (33.3%) | 0.52 |
TIA | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | n.s |
Pre-operative stroke rate | Post-operative stroke rate | p value | |
---|---|---|---|
Total | 2.45 (3.63) | 0.23 (0.77) | < 0.001* |
SCA | 3.19 (3.10) | 0.13 (0.25) | 0.03* |
Trisomy 21 | 0.73 (0.91) | 0.09 (0.19) | 0.25 |
NF1 | 0.00 (0.00) | 0.00 (0.00) | n.s |
MMD | 5.19 (5.16) | 0.63 (1.46) | 0.06 |