Effects and safety of aspirin use in patients after cerebrovascular bypass procedures  

作　　者：Junlin Lu Guangchao Shi Yuanli Zhao Rong Wang Dong Zhang Xiaolin Chen Hao Wang Ji Zong Zhao 

机构地区：[1]Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing,China [2]Neurosurgery,Peking University International Hospital,Beijing,China [3]China National Clinical Research Center for Neurological Diseases,Beijing,China [4]Stroke Center,Beijing Institute for Brain Disorders,Beijing,China [5]Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease,Beijing,China [6]Beijing Translational Engineering Enter for 3D Printer in Clinical Neuroscience,Beijing,China

出　　处：《Stroke & Vascular Neurology》2021年第4期624-630,共7页卒中与血管神经病学（英文）

基　　金：This study is supported by National Key Technology Research and Development Program of the Ministry of Science and Technology of China(2015BAI12B04);Beijing Science and Technology Supporting Plan(D16110000381605);Beijing Municipal Administration of Hospitals’Mission Plan(SML20150501);Beijing Municipal Administration of Hospitals Incubating Program(PX2016034);National Natural Science Foundation of China(81571110,81771234).

摘　　要：Object Superficial temporal artery to middle cerebral artery(STA-MCA)bypass is the most effective treatment for Moyamoya disease(MMD).In this study,we aimed to assess whether aspirin improves STA-MCA bypass patency and is safe in patients with MMD.Methods We performed a retrospective medical record review of patients with ischaemic-onset MMD who had undergone STA-MCA bypass at two hospitals between January 2011 and August 2018,to clarify the effects and safety of aspirin following STA-MCA bypass.The neurological status at the last follow-up(FU)was compared between patients with FU bypass patency and occlusion.Results Among 217 identified patients(238 hemispheres),the mean age was 41.4±10.2 years,and 51.8%were male;the indications for STA-MCA bypass were stroke(48.2%),followed by a transient ischaemic attack(44.0%).Immediate bypass patency was confirmed in all cases.During the FU period(1.5±1.5 y),15 cases were occluded at FU imaging,resulting in an overall cumulative patency rate of 94%.The patency rates were 93%and 94%in the short-term FU group(n=131,mean FU time 0.5±0.2 years)and long-term FU group(n=107,mean FU time 4.1±3.5 years),respectively.The STA-MCA bypass patency rate in the aspirin group was higher than that in the non-aspirin group(98.7%vs 89.7%;HR 1.57;95%CI 1.106 to 2.235;p=0.012).No significant difference in the FU haemorrhagic events was observed between the aspirin and non-aspirin groups.Conclusions Among adult patients with ischaemic-onset MMD undergoing STA-MCA bypass procedures,aspirin might increase the bypass patency rate,without increasing the bleeding risk.FU bypass patency may be associated with a better outcome.Additional studies,especially carefully designed prospective studies,are needed to address the role of aspirin after bypass procedures.

关 键 词：BYPASS ASPIRIN PATIENTS 

分 类 号：R651.12[医药卫生—外科学] R97[医药卫生—临床医学]