Objective: During the cerebral digital subtraction angiography (DSA) follow-up after direct bypass surgery in patients with Moyamoya disease (MMD), we observed different depths of retrograde bypass flow along the original middle cerebral artery (MCA) pathway into the intracranial cavity through the anastomosed recipient vessels. The aim of this study was to investigate the relationship between these varying depths of retrograde bypass flow and the outcomes of revascularization.
Methods: We conducted a retrospective study that included 109 patients (138 hemispheres) diagnosed with MMD and who underwent direct bypass surgery with subsequent DSA follow-up from 2022 to 2023. The study involved categorizing the retrograde flow of blood from superficial temporal artery (STA) into different segments of middle cerebral artery (MCA) as Retrograde Flow Level 1, Retrograde Flow Level 2, and Retrograde Flow Level 3, and correlating these definitions with the Matsushima grading system. We further investigated the correlation between the depth of retrograde bypass flow and fundamental patient characteristics, including sex, age, underlying medical conditions, side of surgery, preoperative diameter of the donor vessel STA, postoperative cerebral hemorrhage or infarction, and compensatory status of the middle meningeal artery and ophthalmic artery preoperatively.
Results: Different retrograde flow levels were correlated with the Matsushima grading (P＜0.001), and preoperative diameter of the donor vessel STA was significantly larger in the Retrograde Flow Level 3 group compared to the Retrograde Flow Level 2 group.
Conclusions: The depth of retrograde flow in the recipient vessel MCA after direct bypass surgery for MMD was positively correlated with the Matsushima grading, which may serve as a novel method for evaluating the effectiveness of postoperative revascularization.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.clineuro.2024.108636 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Successful endovascular therapy with "Direct tip injection in occlusive lesions (DIOL)" fashion for persistent sciatic artery aneurysmal occlusion: A case report.
J Cardiol Cases
December 2024
Department of Cardiology, Asia Medical Group, Sapporo Heart Center, Sapporo Cardio Vascular Clinic, Sapporo, Japan.
Unlabelled: Persistent sciatic artery (PSA) is a rare congenital anomaly that may involve aneurysmal formations. During endovascular treatment for PSA aneurysm (PSAA) occlusion, guidewire crossing can be challenging due to complex anatomy. We report successful endovascular intervention for PSAA occlusion using the "direct tip injection in occlusive lesions (DIOL)" fashion, in which hydraulic pressure with contrast facilitates guidewire crossing by visualizing the vessel course and expanding the microchannel and vessel lumen.
View Article and Find Full Text PDFStaged, hybrid approach by zone 2 arch replacement and completion thoracic endoprosthesis in retrograde acute type A aortic dissection.
J Vasc Surg Cases Innov Tech
February 2025
Department of Cardio-Thoracic Surgery, Radboud Umc, Nijmegen, The Netherlands.
We describe a case of retrograde acute type A aortic dissection approached by a hybrid, staged approach consisting of a zone 2 arch replacement and completion thoracic endovascular aortic repair procedure combined with distal balloon-assisted stent graft dilatation to prevent retrograde false lumen flow. This technique may be an alternative and more complete when compared with a frozen elephant trunk procedure at onset. Additionally, favorable remodeling of the entire thoracic aorta is observed.
View Article and Find Full Text PDFExploring the venous supply of the face: An illustrated overview of contemporary literature.
JPRAS Open
March 2025
Reconstructive Surgery and Regenerative Medicine Research Centre, Institute of Life Sciences, Swansea University Medical School, Swansea, United Kingdom.
Understanding the vascular anatomy of the face is crucial for ensuring safe clinical practices, especially as aesthetic procedures involving hyaluronic acid fillers are gaining popularity. Although vascular complications from these procedures are rare, there has been a documented increase in adverse events linked to venous and arterial occlusions. This review addresses the knowledge gap regarding the facial venous system compared to the well-documented facial artery system, emphasising the importance of thorough anatomical knowledge to mitigate risks during injectable cosmetic procedures.
View Article and Find Full Text PDFEmergence of biphasic versus monotonic response of actin retrograde flow and cell traction force with varying substrate rigidity.
Phys Rev E
November 2024
Department of Physical Sciences, Indian Institute of Science Education and Research Kolkata, Mohanpur 741246, Nadia, West Bengal, India.
The transmission of cytoskeletal forces to the extracellular matrix through focal adhesion complexes is essential for a multitude of biological processes, such as cell migration, cell differentiation, tissue development, and cancer progression, among others. During migration, focal adhesions arrest the actin retrograde flow towards the cell interior, allowing the cell front to move forward. Here, we address a puzzling observation of the existence of two distinct phenomena: a biphasic vs a monotonic relationship of the retrograde flow and cell traction force with substrate rigidity.
View Article and Find Full Text PDFInfluence of Left Subclavian Artery Stent Graft Geometry on Blood Hemodynamics in Thoracic Endovascular Aortic Repair.
J Biomech Eng
December 2024
Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China; Chinese Academy of Sciences, 1068 Xueyuan Avenue, Nanshan District, Shenzhen, China.
Objective: To analyze the hemodynamic changes in different configurations of left subclavian artery (LSA) stent grafts after LSA endovascular reconstruction in thoracic endovascular aortic repair (TEVAR).
Methods: For numerical simulation, one 3D thoracic aortic geometry model with an LSA stent graft retrograde curved orientation was reconstructed from post-TEVAR computed tomography angiography images, and four potential LSA graft configurations were modified and reconstructed: three straight (0, 2 and 10 mm aortic extension) and one anterograde configuration. The blood perfusion of the LSA, flow field, hemodynamic wall parameters and vortex evolution process visualized by the Liutex method were analyzed.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!