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Revisiting flow augmentation bypass for cerebrovascular atherosclerotic vaso-occlusive disease: Single-surgeon series and review of the literature.

Publication ,  Journal Article
Abdelgadir, J; Haskell-Mendoza, AP; Magno, AR; Suarez, AD; Antwi, P; Raghavan, A; Nelson, P; Yang, LZ; Jung, S-H; Zomorodi, AR
Published in: PLoS One
2023

OBJECTIVE: Despite advances in the nonsurgical management of cerebrovascular atherosclerotic steno-occlusive disease, approximately 15-20% of patients remain at high risk for recurrent ischemia. The benefit of revascularization with flow augmentation bypass has been demonstrated in studies of Moyamoya vasculopathy. Unfortunately, there are mixed results for the use of flow augmentation in atherosclerotic cerebrovascular disease. We conducted a study to examine the efficacy and long term outcomes of superficial temporal artery to middle cerebral artery (STA-MCA) bypass in patients with recurrent ischemia despite optimal medical management. METHODS: A single-institution retrospective review of patients receiving flow augmentation bypass from 2013-2021 was conducted. Patients with non-Moyamoya vaso-occlusive disease (VOD) who had continued ischemic symptoms or strokes despite best medical management were included. The primary outcome was time to post-operative stroke. Time from cerebrovascular accident to surgery, complications, imaging results, and modified Rankin Scale (mRS) scores were aggregated. RESULTS: Twenty patients met inclusion criteria. The median time from cerebrovascular accident to surgery was 87 (28-105.0) days. Only one patient (5%) had a stroke at 66 days post-op. One (5%) patient had a post-operative scalp infection, while 3 (15%) developed post-operative seizures. All 20 (100%) bypasses remained patent at follow-up. The median mRS score at follow up was significantly improved from presentation from 2.5 (1-3) to 1 (0-2), P = .013. CONCLUSIONS: For patients with high-risk non-Moyamoya VOD who have failed optimal medical therapy, contemporary approaches to flow augmentation with STA-MCA bypass may prevent future ischemic events with a low complication rate.

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Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2023

Volume

18

Issue

5

Start / End Page

e0285982

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Temporal Arteries
  • Surgeons
  • Stroke
  • Retrospective Studies
  • Postoperative Complications
  • Moyamoya Disease
  • Middle Cerebral Artery
  • Humans
  • General Science & Technology
 

Citation

APA
Chicago
ICMJE
MLA
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Abdelgadir, J., Haskell-Mendoza, A. P., Magno, A. R., Suarez, A. D., Antwi, P., Raghavan, A., … Zomorodi, A. R. (2023). Revisiting flow augmentation bypass for cerebrovascular atherosclerotic vaso-occlusive disease: Single-surgeon series and review of the literature. PLoS One, 18(5), e0285982. https://doi.org/10.1371/journal.pone.0285982
Abdelgadir, Jihad, Aden P. Haskell-Mendoza, Amanda R. Magno, Alexander D. Suarez, Prince Antwi, Alankrita Raghavan, Patricia Nelson, Lexie Zidanyue Yang, Sin-Ho Jung, and Ali R. Zomorodi. “Revisiting flow augmentation bypass for cerebrovascular atherosclerotic vaso-occlusive disease: Single-surgeon series and review of the literature.PLoS One 18, no. 5 (2023): e0285982. https://doi.org/10.1371/journal.pone.0285982.
Abdelgadir J, Haskell-Mendoza AP, Magno AR, Suarez AD, Antwi P, Raghavan A, et al. Revisiting flow augmentation bypass for cerebrovascular atherosclerotic vaso-occlusive disease: Single-surgeon series and review of the literature. PLoS One. 2023;18(5):e0285982.
Abdelgadir, Jihad, et al. “Revisiting flow augmentation bypass for cerebrovascular atherosclerotic vaso-occlusive disease: Single-surgeon series and review of the literature.PLoS One, vol. 18, no. 5, 2023, p. e0285982. Pubmed, doi:10.1371/journal.pone.0285982.
Abdelgadir J, Haskell-Mendoza AP, Magno AR, Suarez AD, Antwi P, Raghavan A, Nelson P, Yang LZ, Jung S-H, Zomorodi AR. Revisiting flow augmentation bypass for cerebrovascular atherosclerotic vaso-occlusive disease: Single-surgeon series and review of the literature. PLoS One. 2023;18(5):e0285982.

Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2023

Volume

18

Issue

5

Start / End Page

e0285982

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Temporal Arteries
  • Surgeons
  • Stroke
  • Retrospective Studies
  • Postoperative Complications
  • Moyamoya Disease
  • Middle Cerebral Artery
  • Humans
  • General Science & Technology