ArticleJournal of neurosurgery2025
Presenting cerebrovascular reactivity as a determinant of direct and indirect surgical revascularization success in North American patients with moyamoya vasculopathy.
Article in Journal of neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Iterative delay correction improves breath-hold cerebrovascular reactivity mapping in clinical populations.Imaging neuroscience (Cambridge, Mass.) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
objectiveBoth direct and indirect surgical revascularization techniques are commonly applied for the treatment of moyamoya disease and syndrome; however, responses can be heterogeneous and efficacy in the context of ischemic disease is not yet formally known from randomized clinical trials. Here, a prospective, longitudinal interventional study was performed to test the hypothesis that presenting 1) parenchymal cerebrovascular reactivity (CVR) and 2) CVR response times portend hemodynamic improvements after direct and indirect revascularization.
methodsCatheter angiography and hypercapnic blood oxygenation-weighted 3-T MRI (spatial resolution 3.5 × 3.5 × 3.5 mm, repetition time 2000 msec) were acquired before and 11.0 ± 7.9 months and 12.6 ± 6.9 months after surgery, respectively. In response to a 5% fixed-inspired CO2 respiratory challenge, time regression analyses were utilized to quantify maximal cerebrovascular reactivity (CVRmax) and time to reach maximal cerebrovascular reactivity (CVRdelay) to test the overarching hypothesis that presurgical measures predicted postsurgical CVRmax increases and CVRdelay reductions. Age, sex, surgical type, and preoperative impairment were considered as relevant explanatory variables in the regression analysis (significance criterion p < 0.05).
resultsA total of 47 operative hemispheres (32 indirect-only and 15 direct or combined direct-indirect revascularization) from 30 adult patients (median [range] age 43 [20-59] years) were evaluated. Direct/combined versus indirect revascularized brain hemispheres were matched for age (44.1 ± 11.1 vs 44.7 ± 13.8 years, p = 0.864), prior infarct (92.9% vs 92.6%, p = 0.976), and Suzuki stage within 1 stage on the 6-point staging scale (4.1 ± 0.7 vs 3.4 ± 0.6). Across all hemispheres and surgical procedures, CVRmax increased (p = 0.022) and CVRdelay decreased (p = 0.009) after surgery; however, responses varied considerably across hemispheres and surgical procedures. On multiple regression analysis, extent of preoperative impairment, quantified as preoperative CVRmax and moderated by the type of surgery performed, was an indicator of intervention-induced outcome in hemodynamics (p = 0.015). No effect of preoperative CVRdelay or age was found for outcomes.
conclusionsThe findings confirm heterogeneous CVR responses approximately 1 year after revascularization across patients, albeit moderated by type of revascularization. Of the variables considered, lower presurgical CVR provided the most significant indicator of the likelihood of postsurgical hemodynamic improvement.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.