烟雾病直接搭桥手术后胶原基质硬脑膜成形术与常规硬脑膜成形术的术后血管形成比较:一项单机构回顾性队列研究

IF 2 Q1 Medicine
Izumi Yamaguchi, Yasuhisa Kanematsu, Kenji Shimada, Masaaki Korai, Takeshi Miyamoto, Shu Sogabe, Manabu Ishihara, Tatsuya Haboshi, Yasushi Takagi
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引用次数: 0

摘要

烟雾病(MMD)的特点是通过硬脑膜侧支循环的发展和血管内皮生长因子(VEGF)和碱性成纤维细胞生长因子(bFBGF)的过度表达。1型胶原促进依赖VEGF和bfbgf的新生血管形成。胶原基质硬脑膜成形术在烟雾病中的有效性尚未被研究,特别是在血管化方面。本回顾性研究旨在评估胶原基质硬膜成形术是否能增强成人发病烟雾病的术后血管化。方法纳入26例(40例)行成人发病烟雾病直接搭桥手术的患者。将患者分为胶原基质组(CMG);n = 17[25次旁路])和对照组(CG;N = 9[15次旁路])。我们将术后血管形成与脑血管造影、单光子发射计算机断层扫描(SPECT)和卒中无生存期进行比较。结果直接旁路术在CMG和CG中的成功率分别为92% %和86.7 %,两组间差异无统计学意义(p = 0.623)。76 %的CMG患者和80 %的CG患者出现了脑膜中动脉红肿,显示了相似的发展(p >; 0.99)。松岛血管造影分级组间具有可比性(良好:CMG 20 %,CG 6.7 %;公平:CMG 72 %,CG 80 %;差:CMG 8 %,CG 13.3 %),差异无统计学意义。CMG患者术后中位相对脑血流量显著增加(术前0.85,术后0.94;p = 0.009),但CG无差异(术前0.93,术后0.94; = 0.455页)。两组间基于硬脑膜成形术的两年无卒中生存率无统计学差异(p = 0.726)。结论胶原基质硬脑膜成形术短期内不能改善成人发病烟雾病患者直接搭桥手术后的血管状况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of postoperative vascularization between collagen matrix duraplasty and conventional duraplasty after direct bypass surgery in Moyamoya disease: A single-institute retrospective cohort study

Background

Moyamoya disease (MMD) is characterized by the development of collateral circulation through the dura mater and overexpression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFBGF). Type 1 collagen promotes VEGF- and bFBGF-dependent neovascularization. The usefulness of collagen matrix duraplasty has not been investigated in MMD, particularly regarding vascularization. The present retrospective study aimed to assess whether collagen matrix duraplasty enhances the postoperative vascularization in adult-onset MMD.

Methods

Twenty-six patients (40 bypasses) who underwent direct bypass surgery for adult-onset MMD were included. The patients were categorized into a collagen matrix group (CMG; n = 17 [25 bypasses]) and a control group (CG; n = 9 [15 bypasses]). We compared postoperative vascularization with cerebral angiography, single-photon emission computed tomography (SPECT), and stroke-free survival.

Results

The direct bypass was patent in 92 % of CMG and 86.7 % of CG, with no significant difference (p = 0.623). Middle meningeal artery blush was observed in 76 % of CMG and 80 % of CG, indicating similar development (p > 0.99). Matsushima angiographic grade was comparable between groups (good: CMG 20 %, CG 6.7 %; fair: CMG 72 %, CG 80 %; poor: CMG 8 %, CG 13.3 %), with no significant differences. The median relative cerebral blood flow significantly increased postoperatively in CMG (preoperative 0.85, postoperative 0.94; p = 0.009) but not in CG (preoperative 0.93, postoperative 0.94; p = 0.455). The two-year stroke-free survival based on duraplasty showed no significant difference (p = 0.726) between groups.

Conclusions

Collagen matrix duraplasty does not enhance the postoperative vascularization status after direct bypass surgery in adult-onset MMD in the short term.
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来源期刊
World Neurosurgery: X
World Neurosurgery: X Medicine-Surgery
CiteScore
3.10
自引率
0.00%
发文量
23
审稿时长
44 days
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