“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Indirect revascularization surgeries, such as encephaloduroarteriosynangiosis and other variants, are generally accepted as standard for pediatric MMD. 3,4,7,9,12 In adult MMD, however, there is still controversy about the effectiveness of some types of revascularization surgeries because there have been no randomized studies to compare the efficacy of surgical techniques, and several retrospective studies have been conducted with various age ranges, small numbers of patients, short-term follow-up, and no standardization of surgical techniques. [5][6][7]10,12,15,16,18,[20][21][22] We aimed to quantitatively evaluate the long-term outcomes of combined revascularization for patients with adult MMD in our institute in terms of clinical, angiographic, and hemodynamic states.…”