Neurosurgery notes/Literature/Vascular papers/Bypass done/Japan Adult Moyamoya (JAM) Trial

Japan Adult Moyamoya (JAM) Trial

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Bypass done

Bottom line

  • Significant difference between surgical and nonsurgical group, suggesting the preventive effect of direct bypass against rebleeding.
  • The difference is pretty minimal and is only significant in the Kaplan Meier analysis (log-rank test)

Design

  • RCT
  • N 80
    • Surgery 42
    • Non-surgery 38

Outcome

  • Primary end point
      • Recurrent bleeding;
      • Completed stroke causing significant morbidity;
      • Significant morbidity or mortality from other medical cause;
      • Requirement for extracranial–intracranial bypass for a nonsurgical patient because of progressive ischemic stroke or crescendo TIAs
      A comparison of the number of patients with an endpoint AI-generated content may be incorrect.
  • Secondary end point
      • Recurrent bleeding occurring later than 3 months after enrolment
      • Related death or significant morbidity.
      A comparison of the number of patients with an endpoint AI-generated content may be incorrect.
  • Details of outcomes and cox regression analysis
      • ㅤ
      Surgical group (n=42)
      Surgical group (n=42)
      Nonsurgical group (n=38)
      Nonsurgical group (n=38)
      Hazard ratio (95% CI)
      P value
      ㅤ
      n
      Rate, %
      n
      Rate, %
      ㅤ
      ㅤ
      Primary end point
      6
      14.3
      13
      34.2
      0.391 (0.148–1.029)
      0.057
      - Recurrent bleeding
      5
      11.9
      12
      31.6
      0.355 (0.125–1.009)
      0.052
      - Completed stroke
      1
      2.4
      0
      0.0
      ...
      ...
      - Crescendo TIA (bypass required)
      0
      0.0
      1
      2.6
      ...
      ...
      Secondary end point (recurrent bleeding or related death/severe disability)
      5
      11.9
      12
      31.6
      0.355 (0.125–1.009)
      0.052

Reference