Background:Superficial temporal artery(STA)-middle cerebral artery(MCA)bypass surgery is now being widely used in moyamoya disease,and its therapeutic value in SICAO remains divergent.Methods:A systematic search was p...Background:Superficial temporal artery(STA)-middle cerebral artery(MCA)bypass surgery is now being widely used in moyamoya disease,and its therapeutic value in SICAO remains divergent.Methods:A systematic search was performed in PubMed,EMBASE,and Cochrane Databases in Feb.2020 and updated in Jun.2019.We have strict inclusion and exclusion criteria.Cochrane Bias Risk Assessment Tool was used to assess the quality of included RCTs.Review Manager 5.3 was used for analysis results in terms of comparing the STA-MCA bypass and BMT.For dichotomous variable outcomes,risk ratios(RRs)and 95%confidence intervals(95%CIs)were calculated for the assessment.Results:The total patient cohort consisted of 2419 patients,of whom 1188(49.1%)patients had been grouped in STA-MCA bypass and 1231(50.9%)patients had been divided into the BMT group.Mean follow-up of included patients was 29 months.The RR of the seven studies was 1.01,and the 95%confidence interval was.89–1.15,with statistical significance,Z=.13,P=.89,sustaining that STA-MCA bypass was not superior to BMT in symptomatic carotid artery occlusion disease.Conclusions:STA-MCA bypass and BMT were associated with similar rates of a composite of long-term stroke.And the risk of long-term overall stroke was mildly higher with BMT.At present,each patient should receive more precise treatment,by reasonably assessing the individual differences of each patient to reduce the recurrence rate of stroke.展开更多
Objective and Importance: The authors report a case of a symptomatic giant serpentine MCA aneurysm treated with double STA-MCA bypass with thrombectomy and excision of aneurysm. This is the first reported case of a do...Objective and Importance: The authors report a case of a symptomatic giant serpentine MCA aneurysm treated with double STA-MCA bypass with thrombectomy and excision of aneurysm. This is the first reported case of a double bypass with concomitant thrombectomy and excision of aneurysmal segment. Clinical Presentation/Methods: We report the case of a 27-year-old Hispanic male with severe acute decline in mental status with a giant serpentine MCA aneurysm with significant mass effect and midline shift trapping the lateral ventricular system. Intervention/Results: Patient presented initially to an outside hospital for altered mental status and confusion. Patient was diagnosed with a giant serpiginous aneurysm and hydrocephalus. A left ventriculoperitoneal shunt was placed at the outside hospital and patient was transferred to University of New Mexico. At this time, his mental status declined rather abruptly. He was treated with a double STA-MCA bypass procedure with aneurysm resection.展开更多
文摘Background:Superficial temporal artery(STA)-middle cerebral artery(MCA)bypass surgery is now being widely used in moyamoya disease,and its therapeutic value in SICAO remains divergent.Methods:A systematic search was performed in PubMed,EMBASE,and Cochrane Databases in Feb.2020 and updated in Jun.2019.We have strict inclusion and exclusion criteria.Cochrane Bias Risk Assessment Tool was used to assess the quality of included RCTs.Review Manager 5.3 was used for analysis results in terms of comparing the STA-MCA bypass and BMT.For dichotomous variable outcomes,risk ratios(RRs)and 95%confidence intervals(95%CIs)were calculated for the assessment.Results:The total patient cohort consisted of 2419 patients,of whom 1188(49.1%)patients had been grouped in STA-MCA bypass and 1231(50.9%)patients had been divided into the BMT group.Mean follow-up of included patients was 29 months.The RR of the seven studies was 1.01,and the 95%confidence interval was.89–1.15,with statistical significance,Z=.13,P=.89,sustaining that STA-MCA bypass was not superior to BMT in symptomatic carotid artery occlusion disease.Conclusions:STA-MCA bypass and BMT were associated with similar rates of a composite of long-term stroke.And the risk of long-term overall stroke was mildly higher with BMT.At present,each patient should receive more precise treatment,by reasonably assessing the individual differences of each patient to reduce the recurrence rate of stroke.
文摘Objective and Importance: The authors report a case of a symptomatic giant serpentine MCA aneurysm treated with double STA-MCA bypass with thrombectomy and excision of aneurysm. This is the first reported case of a double bypass with concomitant thrombectomy and excision of aneurysmal segment. Clinical Presentation/Methods: We report the case of a 27-year-old Hispanic male with severe acute decline in mental status with a giant serpentine MCA aneurysm with significant mass effect and midline shift trapping the lateral ventricular system. Intervention/Results: Patient presented initially to an outside hospital for altered mental status and confusion. Patient was diagnosed with a giant serpiginous aneurysm and hydrocephalus. A left ventriculoperitoneal shunt was placed at the outside hospital and patient was transferred to University of New Mexico. At this time, his mental status declined rather abruptly. He was treated with a double STA-MCA bypass procedure with aneurysm resection.
