ArticleCerebrovascular diseases (Basel, Switzerland)2025
Posterior Cerebral Artery Involvement in Paediatric Moyamoya: Angiographic Patterns and Stroke Burden.
Article in Cerebrovascular diseases (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Endovascular treatment of an inaccessible aneurysm in moyamoya‑like vessels using the floating‑coil technique.Radiology case reports · 2026Article
- Multiterritorial tailored revascularization in adult Moyamoya patients: expanding revascularization approaches to ACA and PCA territories.Neurosurgical review · 2026Article
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4 authors.
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Abstract
<p>Introduction: The posterior circulation is frequently overlooked when managing patients with moyamoya angiopathy, particularly the non-Asian population. This study aimed to identify the presence of angiopathy in the posterior cerebral artery (PCA), its patterns, and the consequences thereof in a paediatric cohort.
methodsRetrospective clinical data, MRI scans, and cerebral angiograms of all patients referred to a single centre for cerebral revascularization were analysed for PCA involvement. Angiographic patterns of PCA involvement were defined. Associated stroke burden was evaluated using general estimation equation regression models adjusting for prespecified potential confounder age at onset, right or left laterality, and involvement of anterior circulation.
resultsPCA involvement was observed in 37% of 122 patients and was identified to be either proximal (proximal P1 segment, P1-posterior communicating artery [Pcomm] segment) or distal (Pcomm-P2 segment and distal P2 segment and beyond). Distal P2 (32%) and involvement of the entire PCA (26%) were most frequently observed. The odds of having any stroke (anterior distribution, i.e., anterior cerebral artery, middle cerebral artery, or posterior distribution, i.e., PCA) was five times higher (odds ratio [OR] 5.0, 95% CI [2.3, 10.9], p < 0.0001) when PCA was involved compared to without PCA involvement. Distal PCA involvement was observed in 59% of children <2 years of age. The OR of stroke in the PCA distribution with distal PCA involvement compared to proximal involvement was 4.1 (95% CI [0.9, 19.0], p = 0.07). The OR of anterior distribution stroke with Pcomm involvement versus no Pcomm involvement was 6.2 (95% CI [1.0, 37.2], p = 0.05).
conclusionInvolvement of the PCA in moyamoya children is highlighted. This may be proximal, distal, or along the entire course of the PCA and is strongly associated with overall stroke. The odds of PCA territory strokes is higher with distal PCA involvement, while involvement of the Pcomm plays a more important role in anterior stroke. Younger children are at higher risk of PCA stroke. </p>.
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