Risk assessment of reperfusion injury after vascular fusion for moyamoya disease

LI Qinggang; RAO Wei; LIANG Yongping; LIU Ruen; ZHANG Jianning; SUN Junzhao

doi:10.3639/j.issn.1671-2897.2025.03.004

Abstract：Objective To assess the risk factors of reperfusion injury after vascular fusion for moyamoya disease.Methods The clinical data of 124 patients with moyamoya disease who underwent vascular fusion in the Department of Neurosurgery of Navy General Hospital from June 2012 to July 2020 were retrospectively analyzed.The incidence rate of reperfusion injury was calculated and the patients were divided into the injured group(n=34)and non-injured group(n=90)based on the occurrence of reperfusion injury.The modified Rankin Scale(mRS)was used to assess the prognosis of the patients.Logistic regression was used to analyze the risk factors affecting the occurrence of postoperative ischemia-reperfusion injury in patients with moyamoya disease.Receiver operating characteristic(ROC)curve was used to analyze the area under the curve(AUC)of different indicators for predicting the occurrence of reperfusion injury.Results The mRS of the injured group was(2.46±0.42),which was significantly higher than that of the non-injured group(1.62±0.31),and the difference was statistically significant(P<0.01);the proportion of bilateral lesions and severe risk patients in the injured group was significantly higher than that in the non-injured group(85.29%vs 38.89%;82.35%vs 42.22%),respect in the injured group was significantly higher than that in the non-injured group[(38.73±5.63)μmol/L vs(25.43±4.51)μmol/L],and the difference was statistically significant(P<0.01).Logistic regression analysis showed that the AUC of bilateral lesions,moderate to severe,homocysteine,and mRS were 0.762,0.731,0.783,and 0.745,respectively.Conclusions The bilateral lesions,moderate to severe,postoperative homocysteine≥30 μmol/L and mRS>2 can be used as the key risk factors of reperfusion injury after vascular recanalization for moyamoya disease.