The Comparison of STA-MCA Bypass and BMT for Symptomatic Internal Carotid Artery Occlusion Disease A Systematic Review and Meta-analysis of Long-term Outcome

2020 ◽  
Author(s):  
Xinyu Yang ◽  
Shifei Cai ◽  
Hao Fan ◽  
Chao Peng ◽  
Yuzhang Wu
Keyword(s):  
Carotid Artery ◽  
Assessment Tool ◽  
Statistical Significance ◽  
Superficial Temporal Artery ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Symptomatic Carotid

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.

scholarly journals The comparison of STA-MCA bypass and BMT for symptomatic internal carotid artery occlusion disease: a systematic review and meta-analysis of long-term outcome

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Shifei Cai ◽  
Hao Fan ◽  
Chao Peng ◽  
Yuzhang Wu ◽  
Xinyu Yang
Keyword(s):  
Carotid Artery ◽  
Assessment Tool ◽  
Statistical Significance ◽  
Superficial Temporal Artery ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Symptomatic Carotid

Abstract Background Superficial temporal artery (STA)-middle cerebral artery (MCA) bypass surgery is 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 ratios (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 and 1231 (50.9%) patients had been divided into the BMT group. Mean follow-up of included patients was 29 months. The RR 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. Conclusions 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 assessing the individual differences of each patient to reduce the recurrence rate of stroke.

scholarly journals Two-component surface replacement implants compared with perichondrium transplantation for restoration of Metacarpophalangeal and proximal Interphalangeal joints: a retrospective cohort study with a mean follow-up time of 6 respectively 26 years

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Muder ◽  
Nils P. Hailer ◽  
Torbjörn Vedung
Keyword(s):  
Primary Outcome ◽  
Statistical Significance ◽  
Surface Replacement ◽  
Level Of Evidence ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Two Component ◽  
Pip Joint

Abstract Background The aim of our study was to compare the long-term outcome after perichondrium transplantation and two-component surface replacement (SR) implants to the metacarpophalangeal (MCP) and the proximal interphalangeal (PIP) joints. Methods We evaluated 163 joints in 124 patients, divided into 138 SR implants in 102 patients and 25 perichondrium transplantations in 22 patients. Our primary outcome was any revision surgery of the index joint. Results The median follow-up time was 6 years (0–21) for the SR implants and 26 years (1–37) for the perichondrium transplants. Median age at index surgery was 64 years (24–82) for SR implants and 45 years (18–61) for perichondium transplants. MCP joint survival was slightly better in the perichondrium group (86.7%; 95% confidence interval [CI]: 69.4–100.0) than in the SR implant group (75%; CI 53.8–96.1), but not statistically significantly so (p = 0.4). PIP joint survival was also slightly better in the perichondrium group (80%; CI 55–100) than in the SR implant group (74.7%; CI 66.6–82.7), but below the threshold of statistical significance (p = 0.8). Conclusion In conclusion, resurfacing of finger joints using transplanted perichondrium is a technique worth considering since the method has low revision rates in the medium term and compares favorable to SR implants. Level of evidence III (Therapeutic).

scholarly journals LONG TERM CLINICAL OUTCOMES AFTER ENDOVASCULAR RECANALIZATION IN PATIENTS WITH CHRONIC CAROTID ARTERY OCCLUSION

2017 ◽  
Vol 69 (11) ◽  
pp. 1006
Author(s):  
Mao-Shin Lin ◽  
Chi-Sheng Hung ◽  
Chih-Fan Yeh ◽  
Ching-Chang Huang ◽  
Ying-Hsien Chen ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Clinical Outcomes ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Endovascular Recanalization

Long-term outcome in symptomatic carotid sinus hypersensitivity

1992 ◽  
Vol 123 (3) ◽  
pp. 687-692 ◽  
Author(s):  
Michele Brignole ◽  
Daniele Oddone ◽  
Stefano Cogorno ◽  
Carlo Menozzi ◽  
Lorella Gianfranchi ◽  
...  
Keyword(s):  
Carotid Sinus ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Symptomatic Carotid ◽  
Carotid Sinus Hypersensitivity

scholarly journals In vivo evidence for long-term vascular remodeling resulting from chronic cerebral hypoperfusion in mice

2016 ◽  
Vol 37 (2) ◽  
pp. 726-739 ◽  
Author(s):  
Tom Struys ◽  
Kristof Govaerts ◽  
Wouter Oosterlinck ◽  
Cindy Casteels ◽  
Annelies Bronckaers ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Emission Tomography ◽  
Resonance Imaging ◽  
Positron Emission ◽  
Common Carotid Artery Occlusion

We have characterized both acute and long-term vascular and metabolic effects of unilateral common carotid artery occlusion in mice by in vivo magnetic resonance imaging and positron emission tomography. This common carotid artery occlusion model induces chronic cerebral hypoperfusion and is therefore relevant to both preclinical stroke studies, where it serves as a control condition for a commonly used mouse model of ischemic stroke, and neurodegeneration, as chronic hypoperfusion is causative to cognitive decline. By using perfusion magnetic resonance imaging, we demonstrate that under isoflurane anesthesia, cerebral perfusion levels recover gradually over one month. This recovery is paralleled by an increase in lumen diameter and altered tortuosity of the contralateral internal carotid artery at one year post-ligation as derived from magnetic resonance angiography data. Under urethane/α-chloralose anesthesia, no acute perfusion differences are observed, but the vascular response capacity to hypercapnia is found to be compromised. These hemispheric perfusion alterations are confirmed by water [15O]-H2O positron emission tomography. Glucose metabolism ([18F]-FDG positron emission tomography) or white matter organization (diffusion-weighted magnetic resonance imaging) did not show any significant alterations. In conclusion, permanent unilateral common carotid artery occlusion results in acute and long-term vascular remodeling, which may have immediate consequences for animal models of stroke but also vascular dementia.

scholarly journals Excimer Laser–Assisted High-Flow Extracranial/Intracranial Bypass in Patients With Symptomatic Carotid Artery Occlusion at High Risk of Recurrent Cerebral Ischemia

Stroke ◽  
2002 ◽  
Vol 33 (10) ◽  
pp. 2451-2458 ◽  
Author(s):  
Catharina J.M. Klijn ◽  
L. Jaap Kappelle ◽  
Albert van der Zwan ◽  
Jan van Gijn ◽  
Cornelis A.F. Tulleken
Keyword(s):  
Cerebral Ischemia ◽  
High Risk ◽  
Carotid Artery ◽  
Excimer Laser ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
High Flow ◽  
Symptomatic Carotid
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