Abstract：
Bypass revascularization helps prevent complications in Moyamoya Disease (MMD). To systematically review complications associated with combined direct and indirect (CB) bypass in MMD and analyze differences between the adult and pediatric populations. A systematic literature review was conducted per PRISMA guidelines. PUBMED, Cochrane Library, Web of Science, and CINAHL, were queried from January 1980 to March 2022. Complications were defined as any event in the immediate post-surgical period of a minimum 3 months follow-up. Exclusion criteria included lack of surgical complication reports, non-English articles, and CB unspecified or reported separately. 18 final studies were included of 1580 procured. 1151 patients (per study range = 10-150, mean = 63.9) were analyzed. 9 (50.0%) studies included pediatric patients. There were 32 total hemorrhagic, 74 total ischemic and 16 total seizure complications, resulting in a rate of 0.04 (95% CI 0.03, 0.06), 0.7 (95% CI 0.04, 0.10) and 0.03 (95% CI 0.02, 0.05), respectively. The rate of hemorrhagic complications in the pediatric showed no significant difference from the adult subgroup (0.03 (95% CI 0.01-0.08) vs. 0.06 (95% CI 0.04-0.10, p = 0.19), such as the rate of ischemic complications (0.12 (95% CI 0.07-0.23) vs. 0.09 (95% CI 0.05-0.14, p = 0.40). Ischemia is the most common complication in CB for MMD. Pediatric patients had similar hemorrhagic and ischemic complication rates compared to adults.
摘要：
旁路血运重建有助于预防烟雾病（MMD）的并发症。系统评价MMD中与直接和间接（CB）联合搭桥相关的并发症，并分析成人和儿童人群之间的差异。根据PRISMA指南进行系统文献综述。pubmed,科克伦图书馆,WebofScience,和CINAHL，从1980年1月到2022年3月被查询。并发症定义为至少3个月随访的术后即刻的任何事件。排除标准包括缺乏手术并发症报告，非英语文章,和CB未指定或单独报告。包括1580项最终研究。分析了1151名患者（每个研究范围=10-150，平均=63.9）。9项(50.0%)研究包括儿科患者。总共有32例出血，74个总缺血和16个总发作并发症，产生0.04的比率(95%CI0.03，0.06)，0.7（95%CI0.04，0.10）和0.03（95%CI0.02，0.05），分别。小儿出血并发症的发生率与成人亚组无明显差异（0.03（95％CI0.01-0.08）与0.06（95%CI0.04-0.10，p=0.19），例如缺血性并发症的发生率（0.12（95％CI0.07-0.23）与0.09（95%CI0.05-0.14，p=0.40）。缺血是CBMMD最常见的并发症。与成年人相比，儿科患者的出血性和缺血性并发症发生率相似。
