Risk Factor Analysis of Transient Ischemic Attack for Moyamoya Disease After a First Combined Revascularization Surgery.

OBJECTIVE

This study aims to elucidate the characteristics and risk factors for transient ischaemic attack (TIA) after the combined revascularization surgical procedure for first diagnosed Moyamoya disease patients.

METHODS

This retrospective study involved 129 patients with Moyamoya disease who underwent their first combined revascularization with the FLOW 800 system at multiple centers from April 2019 to July 2023. Patients were divided into TIA and non-TIA groups according to whether TIA occurred within 6 months postrevascularization. The average real variability (ARV) of systolic blood pressure (SBP) and mean arterial pressure (MAP) was detected with the dynamic blood pressure monitoring.

RESULTS

Of the 129 patients, 33 patients (25.58%) experienced TIA within 6 months postsurgery, and 6 patients (4.65%) developed stroke progression post-TIA. In the TIA group, 30 patients (90.91%) and 3 patients (9.09%) had modified Rankin scale scores of 0-2 and 3-4; in the non-TIA group, 84 patients (87.50%) and 12 patients (12.50%) had modified Rankin scale scores of 0-2 and 3-4, respectively. Univariate analysis revealed that the preoperative limb numbness, hypertension, SBP-ARV, MAP-ARV, Suzuki stages 4-6, and preoperative cerebral perfusion stages 3-4 were risk factors for TIA. Multivariate logistic regression model analysis revealed that the preoperative limb numbness, hypertension, increased SBP-ARV, and increased MAP-ARV were risk factors for TIA. Preoperative SBP-ARV and MAP-ARV were significant risk factors for stroke progression post-TIA.

CONCLUSIONS

Patients who experienced TIA had a relatively high risk of progressing to stroke, which was associated with preoperative SBP-ARV and MAP-ARV.