Combined direct anastomosis and encephaloduroarteriogaleosynangiosis using inverted superficial temporal artery–galeal flap and superficial temporal artery–galeal pedicle in adult moyamoya disease

Kim, Dal Soo; Yoo, Do Sung; Huh, Pil Woo; Kang, Seok‐Gu; Cho, Kyoung Suok; Kim, Moon Chan

doi:10.1016/j.surneu.2006.02.047

Cited by 26 publications

(13 citation statements)

References 29 publications

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“…30,31 Moreover, direct bypass surgery might lead to symptomatic cerebral hyperperfusion postoperatively, and some studies have demonstrated that prophylactic blood pressure lowering can significantly reduce the incidence of symptomatic cerebral hyperperfusion. 32 Finally, to circumvent the poor scalp wound healing that often occurs with direct or combined bypass surgery, 33,34 Kuroda et al 35 modified the STA surgical dissection technique. Although direct bypass surgery has improved a lot, it is still unfit for many MMD patients, and indirect bypass surgery remains an important alternative treatment.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Surgical Treatment for the Secondary Prevention of Stroke in Symptomatic Moyamoya Disease

Qian

Yu²,

Li³

et al. 2015

Medicine

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The treatment of moyamoya disease (MMD) is controversial and often depends on the doctor's experience. In addition, the choice of surgical procedure to treat MMD can differ in many ways. In this study, we performed a meta-analysis to determine whether surgical treatment of MMD is superior to conservative treatment and to provide evidence for the selection of an appropriate surgical treatment.The human case–control studies regarding the association of MMD treatment were systematically identified through online databases (PubMed, Web of Science, Elsevier Science Direct, and Springer Link). Inclusion and exclusion criteria were defined for the eligible studies. The fixed-effects model was performed when homogeneity was indicated. Alternatively, the random-effects model was utilized.This meta-analysis included 16 studies. Surgical treatment significantly reduced the risk of stroke (odds ratio (OR) of 0.17, 95% confidence interval (CI), 0.12–0.26, P < 0.01). A subgroup analysis showed that surgical treatment was more beneficial to hemorrhagic MMD (OR of 0.23, 95% CI, 0.15–0.38, P < 0.01), but there was no significant difference between surgical treatment and conservative treatment on ischemic MMD treatment (OR of 0.45, 95% CI, 0.15–1.29, P = 0.14). Further analysis indicated that compared to direct bypass surgery, indirect bypass surgery had a lower efficacy on secondary stroke risk reduction (OR of 1.79, 95% CI, 1.14–2.82, P = 0.01), while no significant difference was detected for perioperative complications.Surgery is an effective treatment for symptomatic MMD patients, and direct bypass surgery may bring more benefits for these patients.

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Section: Discussionmentioning

confidence: 99%

The Efficacy of Surgical Treatment for the Secondary Prevention of Stroke in Symptomatic Moyamoya Disease

Qian

Yu²,

Li³

et al. 2015

Medicine

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“…Although direct, indirect, or combined direct and indirect bypass has been utilized in patients with MMD, especially with ischemic MMD, it is unclear what the best treatment is for preventing recurrent hemorrhage or ischemic events in adult MMD patients [1,13,14,28,31]. Direct and combined bypasses provide an immediate increase of the blood supply to the ischemic brain compared to indirect bypass, and favorable results have been reported [10,18,20,27]. However, direct bypass has some considerable drawbacks; it is difficult to find both good donor and recipient arteries of sufficient caliber in some patients with moyamoya disease, and some complications are related to direct bypass surgery, such as symptomatic hyperperfusion, cerebral infarction, intracerebral hemorrhage, or even death [7,12,16,27,38].…”

Section: Discussionmentioning

confidence: 99%

“…We performed EDAGS, EDAMS, or EMS as indirect methods [10,32]. Combined bypass surgery was performed by direct STA-MCA anastomosis, and EDAGS was performed using inverted STA-GF/GP [20].…”

Section: Clinical Materials and Methodsmentioning

confidence: 99%

Long-term follow-up results in 142 adult patients with moyamoya disease according to management modality

et al. 2012

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Revascularization surgery was effective in further ischemic stroke prevention to a statistically significant extent. Direct and combined bypasses were more effective to prevent recurrent ischemic stroke than indirect bypass. However, there is still no clear evidence that revascularization surgery significantly prevents rebleeding in adult MMD patients. More significant angiographic changes were observed in direct and combined bypasses compared with indirect bypass.

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“…4,[7][8][9][10][11]16,17,25,29,30,32,34,40,43 Currently, the Ministry of Health and Welfare of Japan reports that bypass surgery is indicated when there are 1) repeated clinical symptoms due to apparent cerebral ischemia and (2) decreased regional cerebral blood flow, vascular response, and perfusion reserve. 6 Some authors have reported a benefit from revascularization in patients presenting with intracranial hemorrhage.…”

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confidence: 99%

Optimal surgical treatment for moyamoya disease in adults: direct versus indirect bypass

Starke¹,

Komotar²,

Connolly³

2009

FOC

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Moyamoya disease is a chronic cerebrovascular occlusive disorder that results in severe morbidity and death. There is much controversy surrounding the optimal treatment for adult patients with the disorder. There have been no randomized trials to assess the efficacy of any single surgical treatment, and existing case series suffer from inadequate power, selection bias, and inherent differences in patient characteristics. In this article the authors review the literature concerning the optimal surgical treatment of adult patients with moyamoya disease.

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Combined direct anastomosis and encephaloduroarteriogaleosynangiosis using inverted superficial temporal artery–galeal flap and superficial temporal artery–galeal pedicle in adult moyamoya disease

Cited by 26 publications

References 29 publications

The Efficacy of Surgical Treatment for the Secondary Prevention of Stroke in Symptomatic Moyamoya Disease

The Efficacy of Surgical Treatment for the Secondary Prevention of Stroke in Symptomatic Moyamoya Disease

Long-term follow-up results in 142 adult patients with moyamoya disease according to management modality

Optimal surgical treatment for moyamoya disease in adults: direct versus indirect bypass

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