Exploring the impact of pre-anastomosis cerebral microcirculation on cerebral hyperperfusion syndrome in superficial temporal artery-middle cerebral artery bypass surgery of moyamoya disease

Wenting Zhu; Tianshu Tao; Jiachi Hong; Ruolan Li; Minghui Ma; Jianjian Zhang; Jincao Chen; Jinling Lu; Pengcheng Li

doi:10.1117/1.NPh.11.3.035008

4 September 2024 Exploring the impact of pre-anastomosis cerebral microcirculation on cerebral hyperperfusion syndrome in superficial temporal artery-middle cerebral artery bypass surgery of moyamoya disease

Wenting Zhu, Tianshu Tao, Jiachi Hong, Ruolan Li, Minghui Ma, Jianjian Zhang, Jincao Chen, Jinling Lu, Pengcheng Li

Author Affiliations +

Neurophotonics, Vol. 11, Issue 3, 035008 (September 2024). https://doi.org/10.1117/1.NPh.11.3.035008

Abstract

Significance

Cerebral hyperperfusion syndrome (CHS), characterized by neurologic deficits due to postoperative high cerebral perfusion, is a serious complication of superficial temporal artery-middle cerebral artery (STA-MCA) surgery for moyamoya disease (MMD).

Aim

We aim to clarify the importance of assessing pre-anastomosis cerebral microcirculation levels by linking the onset of CHS to pre- and post-anastomosis hemodynamics.

Approach

Intraoperative laser speckle contrast imaging (LSCI) measured changes in regional cerebral blood flow (rCBF) and regional blood flow structuring (rBFS) within the cerebral cortical microcirculation of 48 adults with MMD.

Results

Following anastomosis, all MMD patients exhibited a significant increase in rCBF (279.60%±120.00%, p<0.001). Changes in rCBF and rBFS showed a negative correlation with their respective baseline levels (rCBF, p<0.001; rBFS, p=0.005). Baseline rCBF differed significantly between CHS and non-CHS groups (p=0.0049). The areas under the receiver operating characteristic (ROC) curve for baseline rCBF was 0.753. Hemorrhagic MMD patients showed higher baseline rCBF than ischemic patients (p=0.036), with a marked correlation between pre- and post-anastomosis rCBF in hemorrhagic cases (p=0.003), whereas ischemic MMD patients did not.

Conclusion

Patients with low levels of pre-anastomosis baseline CBF induce a dramatic increase in post-anastomosis and show a high risk of postoperative CHS.

CC BY: © The Authors. Published by SPIE under a Creative Commons Attribution 4.0 International License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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Wenting Zhu, Tianshu Tao, Jiachi Hong, Ruolan Li, Minghui Ma, Jianjian Zhang, Jincao Chen, Jinling Lu, and Pengcheng Li "Exploring the impact of pre-anastomosis cerebral microcirculation on cerebral hyperperfusion syndrome in superficial temporal artery-middle cerebral artery bypass surgery of moyamoya disease," Neurophotonics 11(3), 035008 (4 September 2024). https://doi.org/10.1117/1.NPh.11.3.035008

Received: 2 April 2024; Accepted: 1 August 2024; Published: 4 September 2024

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KEYWORDS

Blood circulation

Surgery

Laser speckle contrast imaging

Arteries

Statistical analysis

Cerebral blood flow

Hemodynamics

Significance

Aim

Approach

Results

Conclusion

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