Abstract | OBJECT: METHODS: We performed a retrospective medical record review of patients with ischaemic-onset MMD who had undergone STA-MCA bypass at two hospitals between January 2011 and August 2018, to clarify the effects and safety of aspirin following STA-MCA bypass. The neurological status at the last follow-up (FU) was compared between patients with FU bypass patency and occlusion. Results Among 217 identified patients (238 hemispheres), the mean age was 41.4±10.2 years, and 51.8% were male; the indications for STA-MCA bypass were stroke (48.2%), followed by a transient ischaemic attack (44.0%). Immediate bypass patency was confirmed in all cases. During the FU period (1.5±1.5 y), 15 cases were occluded at FU imaging, resulting in an overall cumulative patency rate of 94%. The patency rates were 93% and 94% in the short-term FU group (n=131, mean FU time 0.5±0.2 years) and long-term FU group (n=107, mean FU time 4.1±3.5 years), respectively. The STA-MCA bypass patency rate in the aspirin group was higher than that in the non- aspirin group (98.7% vs 89.7%; HR 1.57; 95% CI 1.106 to 2.235; p=0.012). No significant difference in the FU haemorrhagic events was observed between the aspirin and non- aspirin groups. CONCLUSIONS: Among adult patients with ischaemic-onset MMD undergoing STA-MCA bypass procedures, aspirin might increase the bypass patency rate, without increasing the bleeding risk. FU bypass patency may be associated with a better outcome. Additional studies, especially carefully designed prospective studies, are needed to address the role of aspirin after bypass procedures.
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Authors | Junlin Lu, Guangchao Shi, Yuanli Zhao, Rong Wang, Dong Zhang, Xiaolin Chen, Hao Wang, Ji Zong Zhao |
Journal | Stroke and vascular neurology
(Stroke Vasc Neurol)
Vol. 6
Issue 4
Pg. 624-630
(12 2021)
ISSN: 2059-8696 [Electronic] England |
PMID | 34039715
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. |
Chemical References |
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Topics |
- Adult
- Aspirin
(adverse effects)
- Cerebral Revascularization
(adverse effects)
- Humans
- Male
- Middle Aged
- Moyamoya Disease
- Prospective Studies
- Retrospective Studies
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