Transient ischemic attack after indirect revascularization surgery for pediatric patients with moyamoya disease: A retrospective study of intraoperative blood pressure
Authors' conclusion
Higher pre-induction baseline blood pressure and ipsilateral MRA score were independent risk factors predicting postoperative TIA in pediatric patients with moyamoya disease after indirect revascularization. The high variability and drastic decline in intraoperative MAP showed predictive value in postoperative symptom progression.
Study context
- Population
- Patients with moyamoya disease younger than 15 years undergoing indirect revascularization under GA, 2013–2019444 hemispheres
- Participants
- 296 patients
- Outcome
- Postoperative TIA
- Follow-up
- Within 2 weeks after surgery
Methodological detailsmixed-effect logistic regression
- Mixed-effect logistic regression
Main finding
As reported in the abstract
Postoperative TIA, cases (of 444 hemispheres)
70
16%
Baseline mean BP, aOR
1.261
95% CI 1.037–1.528P < 0.001
Average mean arterial pressure (MAP), aOR
1.137
95% CI 1.052–1.228P = 0.006
Ipsilateral magnetic resonance angiography (MRA) score, aOR
1.464
95% CI 0.886–2.419P = 0.012
Observational data: associations, not effects.
Further findings
Postoperative symptom progression and its predictors
- Symptom progression, cases
- 34 (7.7%)
- Average real variability of MAP (ARV-MAP), aOR
- 4.731 (95% CI 1.419-15.257; P = 0.003)
- Maximum MAP declination (MaxD-MAP), aOR
- 1.271 (95% CI 1.013-1.520; P = 0.010)
Original publication
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