Lian Liu1, Song Wei Su, Hong Yan Sun. 1. *Nursing School, Southwest Medical University, Luzhou†Basic Medical College, Guangzhou University of Chinese Medicine, Guangzhou University Island, Guangzhou, China.
Abstract
OBJECTIVE: The purpose of this study is to uncover the controversial problems and review the safety of extracranial-intracranial arterial bypass (EC-IC arterial bypass) in the treatment of moyamoya disease. METHODS: Published randomized controlled clinical trials were searched from PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of science without date or language limitations until September 2016. Meta-analysis was performed as recommended by the Cochrane Collaboration of trials. RESULTS: In total 2 studies were included by strict inclusion and exclusion criteria. The result of meta-analysis showed that surgical group had a greater reduction of the primary end points (OR [0.35], 95% CI [0.15, 0.84], I = 0%) than that of the nonsurgical group. CONCLUSION: Surgical therapy significantly lowers incidence of the primary end points (including rebleeding attack; completed stroke resulting in significant morbidity; mortality from any medical cause and requirement for bypass surgery fora nonsurgical patient as determined by a registered neurologist) compared with nonsurgical therapy. High-quality randomized controlled trials are required to confirm this conclusion.
OBJECTIVE: The purpose of this study is to uncover the controversial problems and review the safety of extracranial-intracranial arterial bypass (EC-IC arterial bypass) in the treatment of moyamoya disease. METHODS: Published randomized controlled clinical trials were searched from PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of science without date or language limitations until September 2016. Meta-analysis was performed as recommended by the Cochrane Collaboration of trials. RESULTS: In total 2 studies were included by strict inclusion and exclusion criteria. The result of meta-analysis showed that surgical group had a greater reduction of the primary end points (OR [0.35], 95% CI [0.15, 0.84], I = 0%) than that of the nonsurgical group. CONCLUSION: Surgical therapy significantly lowers incidence of the primary end points (including rebleeding attack; completed stroke resulting in significant morbidity; mortality from any medical cause and requirement for bypass surgery fora nonsurgical patient as determined by a registered neurologist) compared with nonsurgical therapy. High-quality randomized controlled trials are required to confirm this conclusion.
Authors: Markus Kraemer; Rusen Karakaya; Toshinori Matsushige; Jonas Graf; Philipp Albrecht; Hans-Peter Hartung; Peter Berlit; Rudolf Laumer; Frank Diesner Journal: J Neurol Date: 2018-08-28 Impact factor: 4.849