title: Quantitative angiographic comparison with the OSIRIS program between the direct and indirect revascularization modalities in adult moyamoya disease.
abstract: BACKGROUND
  Up-to-date, quantitative angiographic measurement of revascularization extent after bypass surgery has not been reported.
  
  
  OBJECTIVE
  To measure the extent of angiographic revascularization quantitatively 6 months postoperatively with the OSIRIS program (University Hospital of Geneva, version 3.1).
  
  
  METHODS
  A total of 75 bypass procedures were performed in 65 consecutive adult moyamoya disease patients, and 71 bypass surgeries in 61 adult moyamoya disease patients were studied 6 months postoperatively with angiography. We performed 5 different types of bypass surgeries: encephaloduroarteriosynangiosis (EDAS), superficial temporal artery-middle cerebral artery anastomosis (SMA), SMA with encephalomyosynangiosis (EMS), SMA with EDAS, and SMA with encephaloduroarteriomyosynangiosis (EDAMS). We also investigated single-photon emission computed tomography (SPECT) results after 6 months postoperatively and compared the angiographic revascularization extent with the SPECT results.
  
  
  RESULTS
  The mean values for the extent of revascularization among 5 different bypass surgeries were as follows: 32.4% for EDAS only, 57.4% for SMA only, 58.4% for SMA with EMS, 66.1% for SMA with EDAS, and 70.8% for SMA with EDAMS. There was a statistically significant difference in the extent of revascularization among the 5 surgical modalities (P = .000) and between the EDAS-only group and various SMA groups (P = .000). Statistical analysis between angiographic revascularization extent and SPECT results demonstrated significant statistical correlation (P = .000).
  
  
  CONCLUSIONS
  The extent of angiographic revascularization in adult moyamoya disease patients was highest in the SMA with EDAMS group and lowest in the EDAS-only group. In addition, angiographic revascularization extent was well correlated with the change in SPECT.
authors.affiliation: Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Bang
authors.forename: O-Ki
authors.initials: OK
authors.lastname: Kwon
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Kim
authors.forename: Hyun-Seung
authors.initials: HS
authors.lastname: Kang
authors.forename: Hyun
authors.initials: H
authors.lastname: Park
authors.forename: Sung Yun
authors.initials: SY
authors.lastname: Cho
authors.forename: Chang Wan
authors.initials: CW
authors.lastname: Oh
mesh_terms: D000293:Adolescent; D000368:Aged; D002533:Cerebral Angiography / Q000706:statistics & numerical data; D002548:Cerebral Revascularization / Q000706:statistics & numerical data; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D009072:Moyamoya Disease / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D019635:Neurosurgical Procedures / Q000379:methods* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology; D015899:Tomography, Emission-Computed, Single-Photon / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult