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Outcomes in Patients with Moyamoya Syndrome and Sickle Cell Disease: A Systematic Review

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dc.creatorNewman, Sarahspa
dc.creatorBoulter, Jason H.spa
dc.creatorMalcolm, James G.spa
dc.creatorPradilla, Gustavospa
dc.creatorPradilla, Ivanspa
dc.creatorPradilla, Gustavospa
dc.date.accessioned2020-05-26T00:02:31Z
dc.date.available2020-05-26T00:02:31Z
dc.date.created2020spa
dc.description.abstractBackground: Moyamoya syndrome, a progressive, idiopathic stenosis of the internal carotid arteries, results in increased risk for both ischemic and hemorrhagic strokes. Revascularization procedures have been shown in small studies to be both safe and efficacious for these patients; however, randomized controlled trials are lacking. The goal of this systematic review is to organize the literature evaluating surgical intervention versus conservative medical management. Methods: A systematic review was performed including studies with 3 or more participants with moyamoya syndrome in the setting of sickle cell disease and a measured outcome after either medical or surgical intervention. Relevant studies were identified using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria and a set of predetermined key words. Results: Sixty-one articles were identified with 6 articles ultimately included in this review (N = 122). Of the patients, 73 (59.8%) were revascularized surgically (all indirect procedures), whereas 49 (40.2%) remained on chronic transfusion therapy. Of the patients that underwent indirect revascularization surgery, a total of 1 perioperative (1.4%) and 4 postoperative strokes (5.5%) were reported over 44 months (1 stroke per 53.3 patient-years). In comparison, an average of 46.5% of patients who were receiving chronic transfusions had major events (stroke or transient ischemic attack) while undergoing therapy (1 stroke per 13.65 patient-years, P = 0.00215). Conclusions: We present a large systematic review of the literature regarding outcomes of surgical and medical management for patients with moyamoya syndrome and sickle cell disease. The findings redemonstrate the efficacy and safety of surgical revascularization, and advocate for earlier discussion around surgical intervention. © 2019 Elsevier Inc.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1016/j.wneu.2019.11.137
dc.identifier.issn18788750
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/23494
dc.language.isoengspa
dc.publisherElsevier Inc.spa
dc.relation.citationEndPage170
dc.relation.citationStartPage165
dc.relation.citationTitleWorld Neurosurgery
dc.relation.citationVolumeVol. 135
dc.relation.ispartofWorld Neurosurgery, ISSN:18788750, Vol.135,(2020); pp. 165-170spa
dc.relation.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85077447634&doi=10.1016%2fj.wneu.2019.11.137&partnerID=40&md5=ada020c7b1a16f994f3aeb692cc5fe47spa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subject.keywordBlood transfusionspa
dc.subject.keywordCerebral revascularizationspa
dc.subject.keywordCerebrovascular accidentspa
dc.subject.keywordComplicationspa
dc.subject.keywordConservative treatmentspa
dc.subject.keywordHumanspa
dc.subject.keywordMoyamoya diseasespa
dc.subject.keywordPostoperative complicationspa
dc.subject.keywordProceduresspa
dc.subject.keywordSickle cell anemiaspa
dc.subject.keywordTransient ischemic attackspa
dc.subject.keywordTreatment outcomespa
dc.subject.keywordAnemiaeng
dc.subject.keywordBlood transfusionspa
dc.subject.keywordCerebral revascularizationspa
dc.subject.keywordConservative treatmentspa
dc.subject.keywordHumansspa
dc.subject.keywordIschemic attackeng
dc.subject.keywordMoyamoya diseasespa
dc.subject.keywordPostoperative complicationsspa
dc.subject.keywordStrokespa
dc.subject.keywordTreatment outcomespa
dc.subject.keywordChronic transfusion therapyspa
dc.subject.keywordMoyamoya syndromespa
dc.subject.keywordRevascularizationspa
dc.subject.keywordSickle cell diseasespa
dc.subject.keywordStrokespa
dc.titleOutcomes in Patients with Moyamoya Syndrome and Sickle Cell Disease: A Systematic Reviewspa
dc.typearticleeng
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaArtículospa
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