title: Simultaneous superficial temporal artery to middle cerebral or anterior cerebral artery bypass with pan-synangiosis for Moyamoya disease covering both anterior and middle cerebral artery territories.
abstract: Some patients with moyamoya disease treated by conventional surgical procedures may develop postoperative refractory ischemia and perioperative cerebral infarction in the anterior cerebral artery (ACA) territory. We present a novel operative procedure for moyamoya disease to avoid the risk of ischemia in the ACA territory, which consists of simultaneous superficial temporal artery (STA) to middle cerebral artery (MCA) or ACA bypass with pan-synangiosis, encephalo-duro-arterio-myo-synangiosis for the lateral frontal and temporal areas, and encephalo-galeo-arterio-synangiosis for the medial frontal area. This procedure can establish direct bypass to the ACA territory at the first intervention. Simultaneous STA-MCA and STA-ACA bypasses with pan-synangiosis is suitable for patients with moyamoya disease associated with severely impaired perfusion of the ACA territory requiring direct bypass surgery.
authors.affiliation: Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Kamiyama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuroda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yasuda
authors.forename: Naoki
authors.initials: N
authors.lastname: Nakayama
authors.forename: Katsumi
authors.initials: K
authors.lastname: Takizawa
mesh_terms: D000293:Adolescent; D000328:Adult; D002548:Cerebral Revascularization / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009072:Moyamoya Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome