Related Experiment Video
Updated: Sep 11, 2025
05:32
Author Spotlight: Assessing Ischemic Stroke Damage Through Middle Cerebral Artery Occlusion Model
Published on: August 11, 2023
2.2K
Risk Factor Analysis of Transient Ischemic Attack for Moyamoya Disease After a First Combined Revascularization
Shao Zhang1, Jiangong Ma1, Liming Zhao2
1Department of Neurosurgery, The First Affiliated Hospital of Henan University, Kaifeng, China.
World Neurosurgery
|August 15, 2025
Summary
Transient ischemic attack (TIA) after Moyamoya disease (MMD) revascularization is linked to preoperative hypertension and blood pressure variability. These factors also increase the risk of stroke progression post-TIA.
Area of Science:
- Neurosurgery
- Neurology
- Vascular Surgery
Background:
- Moyamoya disease (MMD) is a rare cerebrovascular disorder characterized by progressive stenosis of the internal carotid arteries.
- Combined revascularization surgery is a common treatment for MMD, aiming to restore blood flow to the brain.
- Transient ischemic attack (TIA) is a potential complication following revascularization surgery, necessitating identification of risk factors.
Purpose of the Study:
- To identify the characteristics and risk factors for TIA in patients undergoing their first combined revascularization for MMD.
- To investigate the association between preoperative hemodynamic parameters and the occurrence of TIA.
- To determine risk factors for stroke progression in patients who experience TIA after MMD revascularization.
Main Methods:
- Retrospective analysis of 129 MMD patients who underwent first-time combined revascularization (April 2019-July 2023).
- Patients were categorized into TIA and non-TIA groups based on TIA occurrence within 6 months post-surgery.
- Dynamic blood pressure monitoring was used to assess average real variability (ARV) of systolic blood pressure (SBP) and mean arterial pressure (MAP).
Main Results:
- 33 patients (25.58%) experienced TIA within 6 months post-revascularization.
- Preoperative limb numbness, hypertension, elevated SBP-ARV, elevated MAP-ARV, advanced Suzuki stages (4-6), and high cerebral perfusion stages (3-4) were identified as risk factors for TIA.
- Preoperative SBP-ARV and MAP-ARV were significant predictors of stroke progression post-TIA.
Conclusions:
- Patients experiencing TIA after MMD revascularization have a substantial risk of subsequent stroke.
- Preoperative SBP-ARV and MAP-ARV are critical risk factors for both TIA occurrence and stroke progression in MMD patients.
- Identifying and managing preoperative hemodynamic instability is crucial for improving outcomes after MMD revascularization.
