Impact of RNF213 founder polymorphism (p.R4810K) on the postoperative development of indirect pial synangiosis after direct/indirect combined revascularization surgery for adult Moyamoya disease

Ito, Masaki; Kawabori, Masahito; Sugiyama, Taku et al.

Neurosurgical review, 2022, 45(3), 2305-2313

Permalink : https://hdl.handle.net/2115/89787

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アクセス権
open access
URI
https://hdl.handle.net/2115/89787
タイトル
Impact of RNF213 founder polymorphism (p.R4810K) on the postoperative development of indirect pial synangiosis after direct/indirect combined revascularization surgery for adult Moyamoya disease
著者
Ito, Masaki ; Kawabori, Masahito ; Sugiyama, Taku ; Tokairin, Kikutaro ; Tatezawa, Ryota ; Uchino, Haruto ; Kazumata, Ken ; Houkin, Kiyohiro ; Fujimura, Miki
著者名
Ito, Masaki
e-Rad_Researcher
50399870
著者名
Kawabori, Masahito
e-Rad_Researcher
70748863
著者名
Sugiyama, Taku
著者名
Tokairin, Kikutaro
著者名
Tatezawa, Ryota
著者名
Uchino, Haruto
e-Rad_Researcher
60634144
著者名
Kazumata, Ken
e-Rad_Researcher
90229146
著者名
Houkin, Kiyohiro
e-Rad_Researcher
00361098
著者名
Fujimura, Miki
言語
英語
キーワード
Moyamoya
Magnetic resonance imaging
Polymorphism
Revascularization
RNF213
Vascular disorders
発行日
2022-06
出版者
Springer
収録物名
Neurosurgical review
巻(号)
45(3)
ページ
2305-2313
抄録
Direct superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis combined with indirect pial synangiosis provides favorable surgical collaterals for Moyamoya disease (MMD), especially in adults; however, factors leading to the development of each direct and indirect collateral are not well documented. We aimed to investigate the association between RNF213 founder polymorphism (p.R4810K) and each direct and indirect collateral development. By qualitative and quantitative evaluations of direct and indirect surgical collaterals using time-of-flight MR angiography, postoperative development of each type of bypass was evaluated independently into two categories. Multivariate logistic regression analysis was performed to study the contributing factors for the development of each surgical collateral. Excellent development of postoperative direct and indirect bypass was observed in 65 hemispheres (70%) by qualitative evaluation, which was confirmed by quantitative evaluation. Multivariate logistic regression analysis of excellent indirect bypass development revealed a significant positive correlation with the p.R4810K (odds ratio, OR4.0; 95%-confidence interval, CI 1.2-16), advanced MR angiographic stage (OR9.5; 95%CI 1.7-73), and preoperative middle meningeal artery caliber (OR6.8; 95%CI 1.8-35), but a significant negative correlation was found with the excellent direct bypass development (OR0.17; 95%CI 0.03-0.75). No significant correlation was observed between excellent direct bypass development and the p.R4810K (OR0.95; 95%CI 0.37-2.4). In conclusion, excellent development of indirect collaterals after STA-MCA anastomosis combined with indirect pial synangiosis occurs more frequently in adult MMD with the RNF213 founder polymorphism, suggesting a role of the p.R4810K variant for marked in-growth of indirect collaterals and the utility of preoperative genetic analysis.
資源タイプ
学術雑誌論文
出版タイプ
Accepted Manuscript
権利情報
This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: http://dx.doi.org/10.1007/s10143-022-01749-9
PISSN
0344-5607
関連情報 (isVersionOf)
出版社版DOI
https://doi.org/10.1007/s10143-022-01749-9