Artikel
Clinical implications of cortical microvasculature in adult Moyamoya disease
Suche in Medline nach
Autoren
Veröffentlicht: | 20. Mai 2009 |
---|
Gliederung
Text
Objective: Cortical microvascular surface area (MVSA) and arterial microvascular transit time (AMVTT) have been described to be significantly increased in Moyamoya disease (MMD) patients. It was the aim of our study to investigate the clinical implications of anatomic and functional parameters of cortical microvasculature in MMD patients.
Methods: In 13 MMD patients cortical microvasculature was assessed intraoperatively using ICG-Videoangiography. Microvascular results (MVSA, AMVTT, microvascular density and diameter) were compared to clinical data obtained by digital subtraction angiography (DSA), physical examination and rCBF studies (stable Xenon-enhanced CT) prior to surgery.
Results: MVSA correlated negatively with CVRC (r =–0.636) and positively with AMVTT (r =0.576). Asymptomatic patients were characterized by increased MVSA and significantly increased AMVTT. There was a difference in total microvascular density between asymptomatic (19±0.9 cm/cm²) and symptomatic (17.5±2.2 cm/cm²) patients. No difference was observed in microvascular diameter. Further correlative studies did not show any significant correlation between MVSA vs. angiographic stages, AMVTT vs. DSA stages, AMVTT vs. CVRC and CVRC vs. DSA stages.
Conclusions: Increased MVSA is accompanied by increased AMVTT in MMD patients. Asymptomatic patients are characterized by prolonged AMVTT resulting from increased MVSA and microvascular density. Negative correlation between MVSA and CVRC indicates haemodynamic ischemia as the driving force for neovasculatory activity in MMD.