ArticleStroke (Hoboken, N.J.)2025
Persistent Periventricular Anastomosis Associated With Rebleeding After Bypass Surgery for Hemorrhagic Moyamoya Disease.
Article in Stroke (Hoboken, N.J.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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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.
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Who cites it
1 citing paper in PubMed.
- Impact of anastomosis site on the regression of periventricular anastomosis in moyamoya disease.Acta neurochirurgica · 2025Article
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Although bypass surgery can reduce rebleeding risk in hemorrhagic moyamoya disease, the risk remaining after surgery is not negligible. We hypothesized that the postoperative persistence of periventricular anastomosis (PA), a fragile periventricular collateral manifestation, is associated with rebleeding. Methods: This retrospective cohort study included patients with moyamoya disease who underwent direct bypass at 2 institutions after hemorrhagic presentation. Either presence or absence of PA after surgery was radiologically determined by grading of each subtype, lenticulostriate, thalamic, or choroidal anastomosis, 3-6 months after surgery. The time interval between the surgery and the rebleeding event or last visit was calculated. Results: Of 116 eligible patients comprising 232 hemispheres, 172 hemispheres underwent surgery. Rebleeding occurred in 16 hemispheres of 15 patients (2.0% per person-year) during the median follow-up period of 6.3 years. The hemisphere-based annual rebleeding rate was 2.0% in the PA-positive hemispheres as compared with 0.46% in the PA-negative hemispheres. The adjusted hazard ratio of rebleeding for positive PA relative to negative PA was 4.11 (95% CI, 1.07-15.82). Among subtypes of PA, lenticulostriate anastomosis was the most likely to persist after surgery (34 of 62 anastomoses) and to cause rebleeding (8 of 16 hemispheres). Conclusion: The persistence of PA, especially that of lenticulostriate anastomosis, might be associated with rebleeding after surgery. This suggests the importance of assessing and optimally managing PA for improving long-term outcomes.
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