Direct versus indirect revascularization in the treatment of moyamoya disease

Journal of Neurosurgery
Seong-Eun ParkDong-Seok Kim

Abstract

OBJECTIVE For patients with moyamoya disease (MMD), surgical intervention is usually required because of progressive occlusion of the internal carotid artery. The indirect bypass method has been widely accepted as the treatment of choice in pediatric patients. However, in adult patients with MMD, the most effective treatment method remains a matter of debate. Here, the authors compared the clinical outcomes from MMD patients treated with either extracranial-intracranial arterial bypass (EIAB; 43 hemispheres) or modified encephaloduroarteriosynangiosis (mEDAS; 75 hemispheres) to investigate whether mEDAS is an effective surgical method for treating adults with symptomatic MMD. METHODS A comparative analysis was performed in patients treated using either mEDAS or EIAB. Collateral grading, collateral vein counting, and symptom analysis were used to assess the outcome of surgery. RESULTS Seventy-seven percent (58/75) of mEDAS cases and 83.7% (36/43) of EIAB cases in the analysis experienced improvement in their symptoms after surgery. Furthermore, patients in 98.7% (74/75) of mEDAS cases and those in 95.3% (41/43) of EIAB cases exhibited improved collateral grades. Increases in regions of perfusion were seen after both procedures. ...Continue Reading

References

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Nov 24, 2005·Journal of Neurosurgery·Se-Hyuk KimDong-Seok Kim
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Citations

Dec 20, 2019·Angiologii︠a︡ i sosudistai︠a︡ khirurgii︠a︡ = Angiology and vascular surgery·A R ShabaevA V Mironov
Jul 17, 2020·Curēus·Donya Bani HaniAyah Megahed
Mar 24, 2021·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Jun Kyu HwangKyu-Won Shim
Feb 6, 2021·Journal of Cerebrovascular and Endovascular Neurosurgery·Arvin R WaliAlexander A Khalessi

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Software Mentioned

mEDAS
EIAB
MRA

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