Advances in Research for Moyamoya

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Presentation transcript:

Advances in Research for Moyamoya Edward R. Smith

Transdural collaterals Transdural collaterals are present in nearly half of all moyamoya patients. Transdural collaterals are more common in advanced disease are associated with stroke as a perioperative complication may suggest increased capacity to produce surgical collaterals postoperatively These data support the utility of preoperative arteriograms and this work has reduced intraoperative stroke by >40%. Should we add: only double operations on XRT kids, clinical MRS improved in everyone, only grade C matsushimas are from XRT

What have we done? Metric Low Volume High Volume LOS 6.2 d 4.7 d (32%) Charges $138,000 $88,000 (57%) Nonroutine discharge 8.2 fold higher * Death (any care) 15.7 fold higher  Stroke 2016;47:1303-1311.

We Need Teamwork To Do This