Association between intracranial vascular vulnerability and indirect revascularization development in moyamoya disease

Uchino, Haruto; Ito, Masaki; Kurisu, Kota; Sugiyama, Taku; Fujimura, Miki

Association between intracranial vascular vulnerability and indirect revascularization development in moyamoya disease

Uchino, Haruto; Ito, Masaki; Kurisu, Kota et al.

Neurosurgical review, 2025, 48(1), 387

Permalink : https://hdl.handle.net/2115/97779

このアイテムのアクセス数:45件（2026-08-20 00:15 集計）

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アクセス権	open access
URI	https://hdl.handle.net/2115/97779
タイトル	Association between intracranial vascular vulnerability and indirect revascularization development in moyamoya disease
著者	Uchino, Haruto ; Ito, Masaki ; Kurisu, Kota ; Sugiyama, Taku ; Fujimura, Miki
e-Rad_Researcher 40775144 著者名 Uchino, Haruto
e-Rad_Researcher 10399850 著者名 Ito, Masaki
e-Rad_Researcher 30869839 著者名 Kurisu, Kota
e-Rad_Researcher 70748863 著者名 Sugiyama, Taku
e-Rad_Researcher 00361098 著者名 Fujimura, Miki
言語	英語
キーワード	Moyamoya disease
	Negative remodeling
	Indirect bypass
	FLAIR cortical hyperintensity
	Vascular vulnerability
発行日	2025-04-25
出版者	Springer
収録物名	Neurosurgical review
巻(号)	48(1)
ページ	387
抄録	Negative remodeling, characterized by a decrease in the outer diameter of cerebral arteries, is a hallmark of moyamoya disease (MMD). Postoperative fluid-attenuated inversion recovery (FLAIR) cortical hyperintensity (FCH), indicative of leptomeningeal vasogenic edema, and indirect bypass development are also distinctive features. We investigated the relationships between negative remodeling and these postoperative phenomena. We analyzed 42 hemispheres from 37 adult patients with MMD who underwent combined direct and indirect revascularization. Negative remodeling was assessed by measuring the terminal portion (C1) vessel diameter of the internal carotid artery on preoperative heavy T2-weighted images. FCH was scored from 0 to 6 based on its extent on FLAIR images obtained 2 days postoperatively; indirect bypass development was evaluated qualitatively using magnetic resonance angiography 6 months post-surgery. The participants' median age was 45 years; 76% were female and 90% presented with ischemic onset. The median C1 diameter was 2.39 mm, median FCH score was 2.5, and favorable indirect bypass development was observed in 64% of cases. Smaller preoperative C1 diameters (2.27 mm vs. 3.02 mm, p < 0.0001) and higher FCH scores (median 3 vs. 2, p < 0.05) correlated with favorable indirect bypass development. Smaller C1 diameters also aligned with extensive FCH (2.94 mm vs. 2.20 mm, p < 0.001). Multivariate analysis revealed a significant association between reduced preoperative C1 diameter and favorable indirect bypass development (odds ratio 0.019, 95% confidence interval 0.010-0.17, p < 0.01). These findings suggest that advanced intracranial vascular remodeling in MMD correlates with vascular vulnerability and favorable indirect bypass development.
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/s10143-025-03544-8
PISSN	0344-5607
関連情報	PMID 40274655
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1007/s10143-025-03544-8