Outcomes of Bypass Surgery in Patients with Moyamoya Syndrome Secondary To Sickle Cell Disease: a Multicenter Study.
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Musmar Basel, Roy Joanna M, Abdalrazeq Hammam, Yacoub Celine, Adeeb Nimer, Fuleihan Antony A, Koduri Sravanthi, Baldassari Michael, Lan Matthews, Patel Pious, Momin Arbaz A, Atallah Elias, Alshahrani Rabab, Karadimas Spyridon, Sizdahkhani Saman, Garg Ajay, Naamani Kareem El, Chen Ching-Jen, Jabre Roland, Saad Hassan, Grossberg Jonathan A, Dmytriw Adam A, Patel Aman B, Khorasanizadeh Mirhojjat, Ogilvy Christopher S, Thomas Ajith J, Monteiro Andre, Siddiqui Adnan, Cortez Gustavo M, Hanel Ricardo A, Kasem Rahim Abo, Porto Guilherme, Spiotta Alejandro M, Piscopo Anthony J, Hasan David M, Ghorbani Mohammad, Weinberg Joshua, Nimjee Shahid M, Bekelis Kimon, Salem Mohamed M, Burkhardt Jan-Karl, Zetchi Akli, Matouk Charles, Howard Brian M, Lai Rosalind, Du Rose, Abbas Rawad, Amllay Abdelaziz, Munoz Alfredo, Herial Nabeel A, Tjoumakaris Stavropoula I, Gooch Michael Reid, Notarianni Christina, Guthikonda Bharat, Morcos Jacques, Rosenwasser Robert H, Jabbour Pascal
Аннотация
METHODS: We conducted a multicenter, retrospective cohort study of 553 patients with MMS who underwent surgical revascularization across 13 centers. Patients were grouped by SCD status (SCD-MMS vs. moyamoya disease (MMD)). Primary outcomes included perioperative stroke, perioperative complications, and functional status at discharge. Secondary outcomes included length of stay, and follow-up stroke.
RESULTS: Of 553 patients, 32 (5.8%) had SCD. There were no significant differences in overall perioperative stroke (OR 1.05, 95% CI 0.19 to 5.54), symptomatic perioperative stroke (OR 0.94, 95% CI 0.09 to 8.94), perioperative complications (OR 1.66, 95% CI 0.47 to 5.86), or follow-up stroke (OR 0.88, 95% CI 0.17 to 4.55). Functional outcomes at discharge were similarly favorable in both groups (mRS 0-1: OR 0.84, 95% CI 0.29 to 2.40). SCD was associated with a longer hospital stay (beta 2.78 days, 95% CI 0.60 to 4.96).
CONCLUSION: Surgical revascularization for MMS in patients with SCD does not confer additional procedural risk and yields outcomes comparable to those of patients without SCD. These findings support the role of bypass surgery as a viable treatment option in this high-risk population.