{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T15:38:38Z","timestamp":1790091518354,"version":"4.0.1"},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T00:00:00Z","timestamp":1681430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent studies suggest that cerebral revascularization surgery may be a safe and effective therapy to reduce stroke risk in patients with sickle cell disease and moyamoya syndrome (SCD\u2013MMS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a multicenter, retrospective study of children with SCD\u2013MMS treated with conservative management alone (conservative group)\u2014chronic blood transfusion and\/or hydroxyurea\u2014versus conservative management plus surgical revascularization (surgery group). We monitored cerebrovascular event (CVE) rates\u2014a composite of strokes and transient ischemic attacks. Multivariable logistic regression was used to compare CVE occurrence and multivariable Poisson regression was used to compare incidence rates between groups. Covariates in multivariable models included age at treatment start, age at moyamoya diagnosis, antiplatelet use, CVE history, and the risk period length.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 141 patients with SCD\u2013MMS, 78 (55.3%) in the surgery group and 63 (44.7%) in the conservative group. Compared with the conservative group, preoperatively the surgery group had a younger age at moyamoya diagnosis, worse baseline modified Rankin scale scores, and increased prevalence of CVEs. Despite more severe pretreatment disease, the surgery group had reduced odds of new CVEs after surgery (odds ratio\u00a0=\u00a00.27, 95% confidence interval [CI]\u00a0=\u00a00.08\u20130.94,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.040). Furthermore, comparing surgery group patients during presurgical versus postsurgical periods, CVEs odds were significantly reduced after surgery (odds ratio\u00a0=\u00a00.22, 95% CI\u00a0=\u00a00.08\u20130.58,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>When added to conservative management, cerebral revascularization surgery appears to reduce the risk of CVEs in patients with SCD\u2013MMS. A prospective study will be needed to validate these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.30336","type":"journal-article","created":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T06:48:52Z","timestamp":1681454932000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Cerebral revascularization surgery reduces cerebrovascular events in children with sickle cell disease and moyamoya syndrome: Results of the stroke in sickle cell revascularization surgery retrospective study"],"prefix":"10.1002","volume":"70","author":[{"given":"Philipp R","family":"Aldana","sequence":"first","affiliation":[{"name":"Department of Neurosurgery University of Florida College of Medicine \u2013 Jacksonville and Wolfson Children's Hospital  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo A","family":"Hanel","sequence":"additional","affiliation":[{"name":"Lyerly Neurosurgery Baptist Neurological Institute  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Piatt","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery Nemours Neuroscience Center A.I. duPont Hospital for Children  Wilmington Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7908-7820","authenticated-orcid":false,"given":"Sabrina H","family":"Han","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manisha M","family":"Bansal","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology Nemours Children's Health System and Wolfson Children's Hospital  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7620-1819","authenticated-orcid":false,"given":"Corinna","family":"Schultz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nemours Center for Cancer and Blood Disorders Nemours Children's Hospital  Wilmington Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Gauger","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology Nemours Children's Health System and Wolfson Children's Hospital  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2551-4828","authenticated-orcid":false,"given":"John M","family":"Pederson","sequence":"additional","affiliation":[{"name":"Superior Medical Experts  St. Paul Minnesota USA"},{"name":"Nested Knowledge  St. Paul Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C Wellons","family":"III","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurological Surgery Department of Neurological Surgery Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica L","family":"Hulbert","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori C","family":"Jordan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology Department of Pediatrics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Neurology Zeenat Qureshi Stroke Institute, University of Missouri  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