Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
Neurol Sci. 2021 Jul;42(7):2753-2761. doi: 10.1007/s10072-020-04863-y. Epub 2020 Oct 30.
Cerebrovascular diseases are a leading cause of mortality after liver transplantation (LT). The prevalence of potentially hemorrhagic cerebrovascular diseases (HCVDs) that could cause a hemorrhagic stroke in patients with severe liver diseases has not been reported. We aimed to analyze the underlying prevalence of HCVDs that could lead to hemorrhagic strokes in LT recipients compared with that in previously healthy controls.
A retrospective study with 1,920 consecutive LT recipients and 24,681 adults who underwent a health checkup during the same period was conducted (January 2011-December 2016). The prevalence of cerebral aneurysms (CA), cerebral arteriovenous malformation (AVM), and cavernous malformation (CM) was evaluated using brain imaging, including computed tomography angiography, magnetic resonance imaging, magnetic resonance angiography, and digital subtraction angiography.
The prevalence of CA and CM were 3.1% and 0.5%, respectively, in the LT group and 3.8% and 0.4%, respectively, in the control group. According to the location of the cerebral artery, paraclinoid internal carotid artery aneurysms (odds ratio [OR] 0.440; P = 0.009) had a lower prevalence in LT recipients than in healthy controls. Anterior communicating artery (OR 3.080; P = 0.002) and superior cerebellar artery (OR 8.767; P = 0.017) aneurysms had a higher prevalence in the LT group than in the control. The prevalence of AVM was significantly higher in LT recipients (0.26%) than in healthy controls (0.06%).
LT recipients showed a different distribution of CA prevalence according to the locations of the cerebral artery and had a higher overall prevalence of AVM than previously healthy controls.
脑血管疾病是肝移植（LT）后死亡的主要原因。严重肝脏疾病患者可能导致出血性中风的潜在出血性脑血管疾病（HCVDs）的患病率尚未报道。我们旨在分析 LT 受者中可能导致出血性中风的 HCVD 的潜在患病率，并与先前健康对照组进行比较。
进行了一项回顾性研究，纳入了 1920 例连续的 LT 受者和同期接受健康检查的 24681 例成年人（2011 年 1 月至 2016 年 12 月）。使用脑成像（包括计算机断层血管造影、磁共振成像、磁共振血管造影和数字减影血管造影）评估脑动脉瘤（CA）、脑动静脉畸形（AVM）和海绵状血管畸形（CM）的患病率。
LT 组的 CA 和 CM 患病率分别为 3.1%和 0.5%，对照组分别为 3.8%和 0.4%。根据脑动脉的位置，颈内动脉旁（paraclinoid internal carotid artery）动脉瘤（优势比[OR]0.440；P = 0.009）在 LT 受者中的患病率低于健康对照组。前交通动脉（OR 3.080；P = 0.002）和小脑上动脉（OR 8.767；P = 0.017）动脉瘤在 LT 组中的患病率高于对照组。LT 受者的 AVM 患病率（0.26%）明显高于健康对照组（0.06%）。
LT 受者根据脑动脉的位置显示出 CA 患病率的不同分布，并且 AVM 的总体患病率高于先前健康的对照组。
