Analysis Of The Anterior Choroidal Artery And The Posterior Communicating Artery Grading In DSA Of Adult MMD Patients

Objective:A lot of previous studies had illustrated the correlation between collateral vessels including Ach A,Pch A,Pcom A and PCA in MMD patients and their primary cerebral injuries,in most of which the researchers observed one or several of them respectively and made certain correlations with the primary brain lesion(ie,hemorrhagic and ischemic lesion).Our study is a retrospective research aiming at further estimating the relationship between adult MMD and its collateral vessels by scoring two of these collateral vessels(ie,Ach A and Pcom A)as a whole.Methods:This retrospective research gathered about 62 patients' clinical materials in the neurovascular surgery department of the first Bethune hospital of Jilin University ranging from Sep.2016 to Apr.2017.According to certain inclusive and exclusive criteria,we chose about85 symptomatic hemisphere to do the analysis.We then grouped the patients into hemorrhagic group and ischemic group and subgrouped the hemorrhagic group(see text).All of the diagnosis of MMD was based on the Suzuki 6 stages according to the guidelines set by the Research Committee on Moyamoya Disease(Spontaneous Occlusion of the Circle of Willis)of the Ministry of Health and Welfare of Japan and the scoring of Anterior choroidal artery and Posterior communicating artery was based on the ICA scoring of Suzuki.Lastly,the data is processed by SPSS20.00 Software system.Result:1.the high grade accounted for 60.4%(29/48)of the hemorrhagic group while it accounted for 29.7%(11/37)of the ischemic group,which is statistically significant.(P=0.005<0.05)2.Among 20 SAH patients,the high grade of Ach A-Pcom A accounted for about 81.8%(9/12)aneurysmal SAH but 22.2%(2/9)for non-aneurysmal SAH,which is also statistically significant(Fisher precise test P=0.022<0.05).3.In the preiventricular hemorrhage group,the high grade accounted for about 86.7%(13/15),significantly higher than parenchymal and SAH hemorrhage group(42.9%(6/14),55.0%(11/20)respectively P=0.041?0.05)Conclusion:With the higher scoring of the Ach A-Pcom A,MMD patients are prone to suffer from hemorrhagic lesions which is statistically to the ischemic group,especially the periventricular hemorrhage.It is a promising way to predict the possibility of hemorrhage of adult MMD.Patients with high grade of Ach A-Pcom A suffers from a higher proportion of aneurysmal SAH.In conclusion,the research further approves that the dilation and abnormal branches of Ach A-Pcom A could predict the hemorrhagic risk of MMD patients,especially periventricular hemorrhage.