Trends of Antiplatelet Therapy for the Management of Moyamoya Disease in Japan: Results of a Nationwide Survey.

Abstract

BACKGROUND:

The efficacy and safety of antiplatelet drugs in the treatment of moyamoya disease remain unclear. This study reports results of a nationwide survey conducted in 2016 on the trends of antiplatelet therapy for moyamoya disease in Japan.

METHODS:

Data were obtained through questionnaires related to treatment policies regarding antiplatelet drugs from each specialized stroke management department of 765 hospitals in Japan. Data were also compared between experienced facilities (defined as facilities managing more than 10 cases per year) and those less experienced (not more than 10 cases per year) to determine experts' opinion.

RESULTS:

Of the 389 departments in 375 hospitals that responded, 330 departments provided medical care for moyamoya disease. Regarding ischemic stroke, numerous departments considered the use of antiplatelet drugs "in principle" (218 departments). After surgery for ischemic moyamoya disease, the use of antiplatelet drugs for a certain period of time was the most popular opinion (74 departments). Regarding asymptomatic moyamoya disease, majority departments reported no use of APDs "in principle" (256 departments). The experienced facilities reported "no use of antiplatelet drugs" more frequently than those less experienced for treating asymptomatic moyamoya disease. In moyamoya disease, aspirin was the most commonly used antiplatelet drugs followed by cilostazol and clopidogrel.

CONCLUSIONS:

This survey revealed details of treatment policies, and the selection of antiplatelet drugs widely varied across facilities. Further prospective studies are necessary to improve the current unclear situation regarding the use of antiplatelet drugs for the management of moyamoya disease.

• Authors: Koichi Oki, Masahiro Katsumata, Yoshikane Izawa, Shinichi Takahashi, Norihiro Suzuki, Kiyohiro Houkin, Research Committee on Spontaneous Occlusion of Circle of Willis (Moyamoya disease)
• Journal: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association (J Stroke Cerebrovasc Dis) Vol. 27 Issue 12 Pg. 3605-3612 (Dec 2018) ISSN: 1532-8511 [Electronic] United States
• PMID: 30220629 (Publication Type: Journal Article)
• Copyright: Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Chemical References

• Platelet Aggregation Inhibitors

Topics

• Brain Ischemia (drug therapy, surgery)
• Disease Management
• Humans
• Japan
• Moyamoya Disease (drug therapy, surgery)
• Platelet Aggregation Inhibitors (therapeutic use)