2016
DOI: 10.7150/ijms.15390
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Abstract: Moyamoya disease (MMD) involves progressive occlusion of the intracranial internal carotid artery resulting in formation of moyamoya-like vessels at the base of the brain. It can be characterized by hemorrhage or ischemia. Direct vascular bypass is the main and most effective treatment of MMD. However, patients with MMD differ from those with normal cerebral vessels. MMD patients have unstable intracranial artery hemodynamics and a poor blood flow reserve; therefore, during the direct bypass of superficial tem… Show more

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Cited by 60 publications
(44 citation statements)
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“…The overall wound complication rate at our institution (5.1% major and 1.7% minor wound complications) was at the lower edge of the range reported in the literature. 16,19 The principal novel finding of our study is that combined revascularization using a complete Y-shaped incision tends to cause more wound complications.…”
Section: Discussionmentioning
confidence: 79%
See 1 more Smart Citation
“…The overall wound complication rate at our institution (5.1% major and 1.7% minor wound complications) was at the lower edge of the range reported in the literature. 16,19 The principal novel finding of our study is that combined revascularization using a complete Y-shaped incision tends to cause more wound complications.…”
Section: Discussionmentioning
confidence: 79%
“…2,6 Wound healing disorders including skin necrosis, infection, or CSF leakage are common complications of direct or combined revascularization surgery due to impaired blood supply to the scalp, reaching up to 31%. 5,16,19 The impairment of the scalp microcirculation is not only due to the harvesting of one of the superficial temporal artery (STA) branches, but also due to the impairment of the scalp microvascular network by the preparation of the skin flap. Conventionally, a large skin-galea flap with a separate muscle is prepared using a curved skin incision for a pterional craniotomy for the combined revascularization surgery (STA-middle cerebral artery [MCA] combined with encephalomyosynangiosis [EMS]), as described for an STA-MCA bypass and encephaloduroarteriosynangiosis (EDAS) combined procedure.…”
mentioning
confidence: 99%
“…In the present study, the tortuous type was indicated to be more common than the straight type in the MMD and the non-MMD groups, and there was no significant difference between the two groups. This anatomical trait has a physiological advantage, as higher tortuosity of the STA allows for more effective extension during mandibular joint movement and avoids vascular traction when opening the mouth (6).…”
Section: Discussionmentioning
confidence: 99%
“…MMD is an idiopathic chronic occlusive cerebrovascular disease characterized by stenosis of the terminal internal carotid artery (ICA) and/or the proximal portion of the anterior cerebral artery and/or the middle cerebral artery, as well as development of basal moyamoya vessels (5). At present, extracranial-intracranial bypass is an effective method for the treatment of MMD and the STA is the major source of donor vessels (6). However, whether the STA is also affected in patients with MMD has remained elusive.…”
Section: Introductionmentioning
confidence: 99%
“…Direct revascularization increases the cerebral blood flow and instantly improves cerebral metabolism (14,15), but the drawback is that STA or MCA branches of moyamoya patients may be fragile and easily occluded; thus, the long-term effect of direct revascularization remains elusive. In addition, patients with direct revascularization are prone to developing cerebral hemodynamic disturbances and perioperative complications (16). In addition, recipient vessels of MMD patients always have a small diameter and thin wall, which are difficult to be anastomosed by inexperienced surgeons or hospitals (17,18).…”
Section: Discussionmentioning
confidence: 99%