Abstract Details

Title Clinical and Demographic Characteristics, Natural History and Outcomes in Patients with Moyamoya Vasculopathy in the Canadian population

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 257

Objective To describe demographic, clinical and imaging characteristics, and long-term outcomes in patients with Moyamoya vasculopathy evaluated at a regional subspecialty clinic in Canada.

Background

Moyamoya vasculopathy is a rare and chronic cerebrovascular condition that predisposes to stroke. Due to its rarity and heterogeneity, there is a lack of knowledge in the medical world regarding Moyamoya vasculopathy and the disease is not well characterized.

Design/Methods We retrospectively reviewed data from adult patients with Moyamoya vasculopathy who were evaluated and followed at the Vancouver Stroke Program Moyamoya clinic between 2015 and 2020.

Results Seventy-nine patients were assessed, receiving clinical follow-up over periods ranging from one to thirty years. Moyamoya disease was seen in 62%, and Moyamoya syndrome in 38%. The majority (62%) were female. The commonest race-ethnicity was Asian (65%), followed by white (23%). The majority (86%) were symptomatic at the time of their diagnosis, with median age at symptom onset of 42 years (range 75). The commonest first-time clinical presentations were transient ischemic attack (44%) and ischemic stroke (28%), with 23% presenting with intracerebral hemorrhage, intraventricular hemorrhage or subarachnoid hemorrhage. Symptoms were provoked in 19% of the cases, mostly through exercising and hyperventilating. Initial modified Rankin Score (mRS) at first presentation to clinic was <3 in 84% of cases. Regarding management, most patients were treated with antiplatelet therapy (72%), mostly with aspirin (98%). Half (49%) received surgical management, with ten of them (30%) undergoing bilateral surgery. Direct revascularization was the commonest surgical approach (77%). The perioperative complication rate was 6%, and postoperative complication rate was 20%, most commonly due to seizures. There was one patient death during follow-up.

Conclusions Our Canadian centre follows a large number of individuals with Moyamoya. Further work will compare the clinical characteristics and natural history of our patient population to the clinical experience reported predominantly from centres in Asia.

Authors/Disclosures
Ah Ryung Lim PRESENTER	Miss Lim has nothing to disclose.
Mar Lloret, MD	Dr. Lloret has nothing to disclose.
	No disclosure on file
Thalia S. Field, MD (University of British Columbia)	Dr. Field has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer. Dr. Field has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Field has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AstraZeneca. Dr. Field has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Boston Scientific. Dr. Field has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZeneca. Dr. Field has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Canadian Medical Protective Association, plaintiff. The institution of Dr. Field has received research support from Vancouver Coastal Health Research Institute, Heart and Stroke Foundation of Canada, Brain Canada and CIHR. Dr. Field has a non-compensated relationship as a Editorial board with Stroke that is relevant to �鶹��ýӳ�� interests or activities. Dr. Field has a non-compensated relationship as a Editorial board with CJNS that is relevant to �鶹��ýӳ�� interests or activities. Dr. Field has a non-compensated relationship as a Editorial board with JNNP that is relevant to �鶹��ýӳ�� interests or activities. Dr. Field has a non-compensated relationship as a Board member with DESTINE Health that is relevant to �鶹��ýӳ�� interests or activities. Dr. Field has a non-compensated relationship as a Board Member with Vancouver General Hospital Foundation that is relevant to �鶹��ýӳ�� interests or activities.
	No disclosure on file
Philip A. Teal, MD	Dr. Teal has nothing to disclose.
Samuel Yip, MD, PhD (Samuel Yip MD, FRCPC, INC.)	Dr. Yip has nothing to disclose.

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