Abstract
Background: Superficial temporal artery (STA) - middle cerebral artery (MCA) bypass surgery now being widely used in moyamoya disease, and its therapeutic value in SICAO remains divergent. Methods: A systematic search was performed in PUBMED, EMBASE and Cochrane Databases in Feb.2020, and updated in Jun.2019. We have strict inclusion and exclusion criteria. Cochrane Bias Risk Assessment Tool was used to assess the quality of included RCTs. Review Manager 5.3 was used for analysis results in terms of comparing the STA-MCA bypass and BMT. For dichotomous variable outcomes, Risk Ratio (RRs) and 95% confidence intervals (95%CIs) were calculated for the assessment.Results: The total patient cohort consisted of 2419 patients, of whom 1188(49.1%) patients had been grouped in STA-MCA bypass, 1231(50.9%) patients had divided into BMT group. Mean follow-up of including patients was 29 months. The RRs of the seven studies was 1.01, and the 95% confidence interval was .89-1.15, with statistical significance, Z=.13, P=.89, sustaining that STA-MCA bypass was not superior to BMT in symptomatic carotid artery occlusion disease.Conclusion: STA-MCA bypass and BMT were associated with similar rates of a composite of long-term stroke. And the risk of long-term overall stroke was mildly higher with BMT. At present, each patient should receive more precise treatment, by reasonably assess the individual differences of each patient to reduce the recurrence rate of stroke.
Excimer Laser–Assisted High-Flow Extracranial/Intracranial Bypass in Patients With Symptomatic Carotid Artery Occlusion at High Risk of Recurrent Cerebral Ischemia
