Combined revascularisation for moyamoya disease in paediatrics: a single-centre experience in 86 patients.

OBJECTIVE To evaluate the safety and efficacy of combined revascularisation in paediatric patients with moyamoya disease (MMD).

METHODS A retrospective analysis was conducted on 86 paediatric patients who underwent combined revascularisation at the Department of Neurosurgery of Aviation General Hospital between May 2016 and June 2022. Clinical data, surgical techniques, postoperative complications, and follow-up outcomes were analysed.

RESULTS A total of 151 combined revascularisation procedures were performed in 86 patients. The mean age at surgery was 8.02 ± 3.15 years, with an average follow-up duration of 2.40 ± 1.32 years. Postoperative complications included speech impairment or aphasia (19.2%), seizures (9.3%), cerebral infarction (7.3%), dysphagia (5.3%), subdural effusion (4.6%), poor wound healing (3.3%), cerebral haemorrhage (1.3%), and one mortality (0.7%). Younger age was identified as a risk factor for postoperative haemorrhage (p = 0.040); left-hemisphere surgery was associated with speech impairment or aphasia (p = 0.001, OR = 4.526), and right-hemisphere surgery was linked to cerebral infarction (p = 0.041, OR = 5.072). Symptom improvement and stability rates exceeded 94% at 2 weeks and 3 months postoperatively, with significant improvements in modified Rankin Scale (mRS) scores compared with preoperative values (p < 0.05).

CONCLUSION Combined revascularisation is a safe and effective treatment for paediatric MMD, with favourable long-term outcomes.