RT Journal Article
SR Electronic
T1 Lateral Posterior Choroidal Collateral Anastomosis Predicts Recurrent Ipsilateral Hemorrhage in Adult Patients with Moyamoya Disease
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A6208
A1 J. Wang
A1 Y. Yang
A1 X. Li
A1 F. Zhou
A1 Z. Wu
A1 Q. Liang
A1 Y. Liu
A1 Y. Wang
A1 S. Na
A1 X. Chen
A1 X. Zhang
A1 B. Zhang
YR 2019
UL http://www.ajnr.org/content/early/2019/09/19/ajnr.A6208.abstract
AB BACKGROUND AND PURPOSE: Choroidal collateral anastomosis is associated with hemorrhage recurrence in patients with Moyamoya disease. However, the relationship between recurrent ipsilateral hemorrhage and choroidal collateral anastomosis subtypes (anterior choroidal artery anastomosis, lateral posterior choroidal artery anastomosis, and medial posterior choroidal artery anastomosis) is unclear. This study aimed to assess this potential association in adult patients with Moyamoya disease.MATERIALS AND METHODS: Patients angiographically diagnosed with Moyamoya disease who underwent conservative treatment between January 2008 and December 2018 were included in this retrospective study. Two readers assessed the angiographic images to identify choroidal collateral anastomosis subtypes, and Cox proportional hazard regression models were used to estimate the risk of recurrent hemorrhage associated with each subtype.RESULTS: Thirty-nine patients (mean age = 45.2 years) were included in this study. During 52.4 ± 37.0 months of follow-up, recurrent ipsilateral hemorrhage occurred in 48.7% (19/39) of patients. Patients with recurrent hemorrhage had a higher prevalence of choroidal collateral (94.8% versus 60.0%; P = .02) and lateral posterior choroidal artery (78.9% versus 25.0%; P < .01) anastomoses than those without recurrent hemorrhage. Lateral posterior choroidal artery anastomosis was associated with recurrent hemorrhage before (hazard ratio = 6.66; 95% CI, 2.18–20.39; P < .01) and after (hazard ratio = 5.78; 95% CI, 1.58–21.13; P < .01) adjustments were made for age, sex, and other confounding factors.CONCLUSIONS: Choroidal collateral anastomosis is responsible for most cases of recurrent hemorrhage in adult patients with Moyamoya disease; lateral posterior choroidal artery anastomosis is a significant risk factor for these recurrent events.AChAanterior choroidal arteryChCAchoroidal collateral anastomosisHRhazard ratioLPChAlateral posterior choroidal arteryMMDMoyamoya diseaseMPChAmedial posterior choroidal artery