Surgical treatment of moyamoya disease in adults: combined direct and indirect vs. indirect bypass surgery.
Combined superficial temporal artery-middle cerebral artery anastomosis and encephalo-duro-arterio-galeo-synangiosis (EDAGS) were retrospectively compared with indirect bypass, EDAGS with or without inversion, in 134 hemispheres of 96 adult patients with non-hemorrhagic moyamoya disease (MMD) in terms of angiographic findings, perioperative complications, and clinical outcome. Angiographic revascularization seemed to be better in the combined bypass group compared with the EDAGS group (p = 0.045), but perioperative complication tended to be slightly more common in the combined bypass group. No statistical differences were found in clinical outcome. EDAGS is a very reliable alternative to combined bypass in adult MMD. However, randomized clinical trials are needed to assess the long-term efficacy of any bypass surgery in adult patients with MMD.
Department of Neurosurgery, Myong-Ji St. Mary's Hospital, Seoul, Republic of Korea.
Dal-Soo
DS
Kim
Pil-Woo
PW
Huh
Hyung-Seok
HS
Kim
In-Soo
IS
Kim
Seokmin
S
Choi
Jin-Ho
JH
Mok
Choon-Woong
CW
Huh
D000293:Adolescent; D000328:Adult; D000368:Aged; D002548:Cerebral Revascularization / Q000379:methods* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009072:Moyamoya Disease / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality* / Q000503:physiopathology; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult