gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Age dependent revascularization patterns in the treatment of Moyamoya Disease

Altersabhängige Revaskularisierungsmuster bei der Behandlung der Moyamoya Erkrankung

Meeting Abstract

Suche in Medline nach

  • corresponding author P. Horn - Klinik für Neurochirurgie, Universitätsklinikum Mannheim
  • P. Vajkoczy - Klinik für Neurochirurgie, Universitätsklinikum Mannheim
  • P. Schmiedek - Klinik für Neurochirurgie, Universitätsklinikum Mannheim

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc11.05.-09.05

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0215.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Horn et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective

The influence of age on the success of combined revascularization techniques in the treatment of Moyamoya (MM) patients has not been investigated so far. The aim of the present study was to analyse the relative contribution of direct (standard STA-MCA arterial bypass) and indirect (Encephalo-myo-synagngiosis; EMS) bypass surgery on restoration of cerebral blood supply in pediatric and adult MM patients.

Methods

20 (10 pediatric, 10 adult) MM patients underwent a total of 38 combined revascularization procedures (STA-MCA bypass & EMS). Serial conventional digital subtraction angiography (DSA) studies (range: 2 – 4 per patient) were performed in the early post operative period and at variable time intervals thereafter (range of follow-up: 6 – 54 months). Bypass patency and EMS-function were assessed separately by angiographic means using a 3 point grading scale (poor - I, moderate - II, extensive – III).

Results

The bypass patency in adults and pediatric patients was 95% and 94%, respectively. However, direct bypasses were characterized by a worse function in pediatric patients when compared to adults. In contrast, indirect revascularization by EMS was more successful in pediatric patients. All pediatric patients developed a sufficient blood supply via the EMS (grade I: n=0; grade II: n=12; grade III: n=8) within 3 months post surgery. In adult patients the success of revascularisation via the EMS was dependent on the function of the direct bypass: no indirect revascularization was observed in patients with extensive bypass function (n=3); successful indirect revascularization (grade I: n=11; grade I: n=4; grade III: n=1) was observed in patients with poor/moderate bypass function (n=15).

Conclusions

The success of both direct and indirect revascularization procedures depends on the age of MM patients. Indirect techniques, which depend on the formation of new cerebral blood vessels, tend to contribute more to the restoration of cerebral blood supply in pediatric patients when compared to STA-MCA bypass surgery.