Predictors of Dura-Brain Neoangiogenesis After Combined Revascularization for Patients with Symptomatic Atherosclerotic Cerebral Artery Occlusion: A Multivariate Regression Analysis.

OBJECTIVE

To investigate the independent predictors of dura-brain neoangiogenesis (DBN) after superficial temporal artery-to-middle cerebral artery bypass combined with dural inversion in patients with symptomatic atherosclerotic cerebral arterial occlusion (SACAO).

METHODS

We retrospectively analyzed SACAO patients who underwent superficial temporal artery-to-middle cerebral artery bypass combined with dural inversion at our center between November 2014 and October 2021. DBN was evaluated by superselective digital subtraction angiography and scored by the DBN scoring system. Independent predictors of DBN were identified by a multivariate logistic regression analysis. The differences in clinical outcomes between patients with "good" and "poor" DBN were also analyzed.

RESULTS

A total of 179 SACAO patients with an average age of 61.3 ± 7.0 years and an average follow-up of 63.0 ± 22.0 months were studied. Ninety-nine patients (55.3%) had good DBN, and 80 patients (44.7%) had poor DBN. The multivariate analysis revealed that old age (P < 0.001, odds ratio [95% confidence interval] 1.288 [1.184-1.400]) was an independent predictor of poor DBN. Diabetes (P = 0.005, odds ratio [95% confidence interval] 3.358 [1.434-7.867]) also independently predicted poor DBN. The recurrence rate of ischemic events in the good DBN group was significantly lower than that in the poor DBN group (2.0% vs. 10.0%, P = 0.044). The neurological status of patients in the good DBN group was also significantly better.

CONCLUSIONS

Old age and diabetes status were independent predictors of poor DBN after combined revascularization in SACAO patients. Good DBN was associated with a lower recurrence rate of stroke and better neurological status.