Risk Factor Analysis of Transient Ischaemic Attack for Moyamoya Disease after a First Combined Revascularization Surgery.

Objective: This study aims to elucidate the characteristics and risk factors for transient ischaemic attack (TIA) after the combined revascularization surgical procedure for first diagnosed Moyamoya disease (MMD) patients.

Methods: This retrospective study involved 129 patients with MMD who underwent their first combined revascularization with the FLOW 800 system at multiple centers from April 2019 to July 2023. Patients were divided into TIA and non-TIA groups according to whether TIA occurred within 6 months post-revascularization. The average real variability (ARV) of systolic blood pressure (SBP) and mean arterial pressure (MAP) was detected with the dynamic blood pressure monitoring.

Results: Of the 129 patients, 33 patients (25.58%) experienced TIA within 6 months post-surgery, and 6 patients (4.65%) developed stroke progression post-TIA. In the TIA group, 30 patients (90.91%) and 3 patients (9.09%) had modified Rankin scale (mRS) scores of 0-2 and 3-4; in the non-TIA group, 84 patients (87.50%) and 12 patients (12.50%) had mRS scores of 0-2 and 3-4, respectively. Univariate analysis revealed that the preoperative limb numbness, hypertension, SBP-ARV, MAP-ARV, Suzuki stages 4-6, and preoperative cerebral perfusion stages 3-4 were risk factors for TIA. Multivariate logistic regression model analysis revealed that the preoperative limb numbness, hypertension, increased SBP-ARV, and increased MAP-ARV were risk factors for TIA. Preoperative SBP-ARV and MAP-ARV were significant risk factors for stroke progression post-TIA.

Conclusions: Patients who experienced TIA had a relatively high risk of progressing to stroke, which was associated with preoperative SBP-ARV and MAP-ARV.