Moyamoya Disease Clinical Trial
Official title:
Effect of Surgical Revascularization and Conservative Treatment on Hemorrhagic Moyamoya Disease
Moyamoya Disease(MMD), also known as spontaneous basilar artery occlusion, is characterized by the gradual thickening of arterial intima at the distal carotid artery and the proximal portion of anterior/middle cerebral artery, the gradual stenosis or occlusion of arterial lumen, and the compensatory expansion of basilar cerebral perforating arteries. Cerebral infarction and cerebral hemorrhage are common clinical symptoms of MMD with high morbidity of disability. For ischemic moyamoya disease, intracranial/extracranial revascularization is the preferred treatment. However, for patients with hemorrhagic moyamoya disease, there is controversy about whether to have surgical treatment, the timing and the method of surgical treatment, and the effect of surgical treatment to prevent rebleeding due to the lack of large sample, multi-center, prospective randomized studies. At present, the studies on the effect of revascularization and conservative treatment on hemorrhagic moyamoya disease are retrospective case analyses without randomized control. The sample size of these studies are small, and the conclusions obtained are inconsistent. Due to the differences in the epidemiology and episode type of moyamoya disease in different countries, there is no prospective, randomized controlled study of blood type moyamoya disease in China to confirm the efficacy of revascularization and lack of uniform norms and standards.
Objective: The aim of this study is to perform a prospective, randomized study on hemorrhagic
moyamoya disease to confirm the effect of revascularization in China, and to establish
specifications and standards to guide the treatment options for hemorrhagic moyamoya disease
as well.
Design: This study is a single-center study and plan to include 108 patients. According to a
random number table, hemorrhagic moyamoya patients will be assigned to three groups:
conservative treatment group, direct revascularization group and indirect revascularization
group. A prospective, randomized study will be carried out to evaluate the effect of
revascularization and conservative treatment on the reduction of rebleeding risk and
improvement of ischemia in adult patients with hemorrhagic moyamoya disease.
Observation Measures: 1.Rebleeding; 2.Cerebral infarction resulting in severe disability (mRS
scoreā„3); 3.Severe disability or death caused by other reasons; 4. Patients in conservative
treatment group need revascularization due to progressive ischemic stroke or progressive
Transient ischemic attack(TIA).
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