The Collateral Circulation in Moyamoya Disease: a Single Center Experience in 140 Pediatric Patients

Publication date: Available online 14 September 2017
Source:Pediatric Neurology
Author(s): Meng Zhao, Dong Zhang, Shuo Wang, Yan Zhang, Xiaofeng Deng, Jizong Zhao
BackgroundThe patterns and clinical significance of the presence of collaterals in moyamoya disease has not been elucidated thoroughly. This study aimed to summarize the clinical features of collaterals in pediatric moyamoya disease.Basic proceduresWe reviewed consecutive pediatric patients with moyamoya vasculopathy who were admitted to our hospital from 2009 to 2015. Only pediatric moyamoya patients with digital subtraction angiography examinations were included in this study. We classified spontaneous collaterals into two groups by their origins, the internal carotid artery and vertebral artery (ICA-VA) originated collaterals and the external carotid artery (ECA) originated collaterals.Main findingsA total of 140 pediatrics with moyamoya disease (mean age, 10.1 ± 3.7 years) were included in this study. We identified collaterals originated from ICA-VA in 122 (87.1%) pediatric patients (222 hemispheres). Patients in the ICA-VA collaterals group had similar Suzuki stages with patients without collaterals originated from ICA-VA. (mean, 3.86 vs. 3.50; P=0.157). We identified collaterals originated from ECAs in 70 (50.0%) pediatric patients (106 hemispheres) with moyamoya disease. The infarctions were more common in patients with ECA originated collaterals than in patients without ECA originated collaterals (25 vs. 12, P=0.021).Principal conclusionsOur results demonstrate collaterals originated from ECAs are associated with advanced Suzuki stages and infarction presentations in pediatric moyamoya disease.



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