Intraoperative FFR and FLOW800 imaging predict postoperative perfusion abnormalities in Moyamoya bypass patients.
This retrospective analysis examined 26 patients with Moyamoya disease who underwent superficial temporal artery–middle cerebral artery (STA-MCA) bypass at a single institution. The primary exposure was intraoperative FFR pressure wire measurements combined with FLOW800 imaging analysis. The main outcome assessed was the occurrence of postoperative cerebral perfusion abnormalities.
postoperative cerebral perfusion abnormalities were observed in 9 of 26 patients (34.6%). Additionally, diffusion-weighted MRI (DWI)-confirmed acute ischemic lesions occurred in 3 patients (11.5%), and transient neurological symptoms were reported in 6 patients. The study evaluated the predictive value of a pressure drop (ΔP) greater than 32 mmHg, which demonstrated a sensitivity of 77.8% and a specificity of 64.7%.
When assessing predictive capability, the combined use of ΔP and resistance time (RT) yielded an area under the receiver operating characteristic (ROC) curve (AUC) of 0.82 (95% CI, 0.61–0.99). For comparison, ΔP alone and RT alone each produced an AUC of 0.79. No adverse events, serious adverse events, discontinuations, or specific tolerability data were reported in this cohort.
A key limitation of this study is its retrospective design and small sample size, which preclude causal inference. The authors note that larger prospective studies are required before these metrics can be recommended for routine decision-making. Given the institutional setting and lack of a formal comparator group, the generalizability of these findings remains uncertain. These results suggest potential utility in intraoperative settings but require validation in broader populations.
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