• World Neurosurg · Oct 2019

    Preservation of the Arachnoid Membrane during Encephaloduroarteriosynangiosis (EDAS) Reduces Post-Operative Complications Without Undermining the Surgical Outcome in Pediatric Moyamoya Disease.

    • Yoon Hwan Byun, Ji Hoon Phi, Ji Yeoun Lee, Eun Jin Ha, Kyung Hyun Kim, Jeyul Yang, Hee-Soo Kim, Seul Ki Ryu, Jung Won Choi, Byung-Kyu Cho, and Seung-Ki Kim.
    • Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
    • World Neurosurg. 2019 Oct 1; 130: e406-e416.

    BackgroundEncephaloduroarteriosynangiosis (EDAS) is a commonly used indirect revascularization operation method to treat pediatric patients with Moyamoya disease (MMD). Arachnoid dissection frequently has been performed during the EDAS operation to promote better revascularization. However, no studies have yet proven its surgical benefits. In this study, we investigated the impact of arachnoid preservation on the surgical outcome and postoperative complication by comparing pediatric patients with MMD who had the arachnoid membrane preserved during EDAS operation with those who had it dissected.MethodsThis was a retrospective cohort study based on a single surgeon's experience at a single institution. A total of 206 pediatric patients with MMD who underwent EDAS operation at Seoul National University Children's Hospital were recruited for the study. We compared the surgical outcome and the postoperation complication rate of these 2 groups. Furthermore, risk factors for postoperative complication were analyzed.ResultsThe overall clinical outcome (P = 0.342) and the extent of revascularization of middle cerebral artery territories (P = 0.736) were not different between the arachnoid dissection group and the arachnoid preservation group. However, the postoperative infarction/hemorrhage rate was significantly greater in the arachnoid dissection group (P = 0.005). Arachnoid dissection (P = 0.011) and young age (<3 years old, P = 0.012) were significantly associated with increased risk of postoperative complications.ConclusionsArachnoid preservation may help to reduce postoperative complications without decreasing the surgical outcome of EDAS. Furthermore, factors such as the patient's age should be taken into account when treating pediatric patients with MMD.Copyright © 2019 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…