Safety of Extracranial-Intracranial Arterial Bypass in the Treatment of Moyamoya Disease.

Objective: The purpose of this study is to uncover the controversial problems and review the safety of extracranial-intracranial arterial bypass (EC-IC arterial bypass) in the treatment of moyamoya disease. Methods: Published randomized controlled clinical trials were searched from PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of science without date or language limitations until September 2016. Meta-analysis was performed as recommended by the Cochrane Collaboration of trials. Results: In total 2 studies were included by strict inclusion and exclusion criteria. The result of meta-analysis showed that surgical group had a greater reduction of the primary end points (OR [0.35], 95% CI [0.15, 0.84], I2 = 0%) than that of the nonsurgical group. Conclusion: Surgical therapy significantly lowers incidence of the primary end points (including rebleeding attack; completed stroke resulting in significant morbidity; mortality from any medical cause and requirement for bypass surgery fora nonsurgical patient as determined by a registered neurologist) compared with nonsurgical therapy. High-quality randomized controlled trials are required to confirm this conclusion. (C) 2017 by Mutaz B. Habal, MD.

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