Zhao M, et al. – Researchers carried out this study to clarify the clinical features, surgical treatment and long–term outcomes of adolescent patients with moyamoya disease. They revealed that in preventing future strokes, direct/combined bypass could be more effective than indirect bypass in adolescent patients with moyamoya disease.

• From 2009 to 2015, the researchers reviewed consecutive patients with moyamoya vasculopathy who were admitted to their hospital to identify adolescent patients with moyamoya disease.
• They examined clinical features, surgical treatment and long-term outcomes.
• They performed follow-up by face-to-face or structured telephone interviews.
• Future stroke events were outcome measures.
• Univariate and multivariate time-to-event analyses were performed to identify risk factors associated with future stroke events.

• The researchers included 95 adolescent patients with moyamoya disease (age at onset, 13.1 ± 2.3 years) in this study.
• 12 patients (12.6%) had stroke events during follow-up.
• They found that compared to patients who underwent indirect bypass, the patients who underwent direct/combined bypass had a significantly lower risk of future strokes [hazard ratio (HR), 0.16; 95% confidence interval (CI), 0.03–0.74; P = 0.019].