Effects of aspirin and heparin treatment on perioperative outcomes in patients with Moyamoya disease.
Acta Neurochir (Wien)
; 163(5): 1485-1491, 2021 05.
Article
en En
| MEDLINE
| ID: mdl-33404873
ABSTRACT
BACKGROUND:
When superficial temporal artery-middle cerebral artery bypass is combined with indirect methods (e.g., revascularization surgery) to treat Moyamoya disease (MMD), antiplatelet treatment can impact bypass patency, infarction, or hemorrhage complications. Recently, heparin has been proposed as an anticoagulant treatment against white thrombus at the anastomosis site. The study aims to evaluate the effect of aspirin on the perioperative outcomes and investigate the results of heparin treatment for white thrombus.METHODS:
This retrospective study included 74 procedures of combined revascularization surgery for MMD patients who either received or did not receive aspirin. Perioperative outcomes were compared between the two groups. In addition, the effects of heparin treatment for white thrombus were evaluated.RESULTS:
The rate of white thrombus at the anastomosis site was significantly higher in the non-aspirin medication group (univariate p = 0.032, multivariate p = 0.044) and, accordingly, initial bypass patency was lower in the non-aspirin medication group (p = 0.049). Of the 17 patients with white thrombus development, five received heparin injections, and all white thrombi disappeared; however, there was one case of epidural hematoma and another of subdural hematoma. The risk of hemorrhagic complications was significantly higher in the surgical procedures that received heparin injections (p = 0.021).CONCLUSIONS:
In MMD patients who received combined revascularization surgery, aspirin medication lowered the occurrence of white thrombus. Heparin injections help to treat white thrombus but can enhance the risk of hemorrhagic complications.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Heparina
/
Revascularización Cerebral
/
Aspirina
/
Enfermedad de Moyamoya
/
Anticoagulantes
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Acta Neurochir (Wien)
Año:
2021
Tipo del documento:
Article
País de afiliación:
Japón