{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:52:00Z","timestamp":1790754720263,"version":"4.1.0"},"publisher-location":"Cham","reference-count":23,"publisher":"Springer Nature Switzerland","isbn-type":[{"value":"9783031898433","type":"print"},{"value":"9783031898440","type":"electronic"}],"license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"vor","delay-in-days":190,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Objective<\/jats:italic>\n                    : Revascularization surgery such as superficial temporal artery\u2013middle cerebral artery (STA-MCA) bypass is a standard management choice for symptomatic moyamoya disease (MMD) patients, with either ischemic or hemorrhagic presentation. We sought to clarify the efficacy and safety of institutional standardized revascularization procedures for MMD.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Materials and methods<\/jats:italic>\n                    : The present study includes 37 consecutive patients with MMD (2\u201360\u00a0years old, 42.0 on average) undergoing revascularization surgery on 42 affected hemispheres. Direct-indirect combined revascularization surgery was performed on most hemispheres (41\/42, 97.6%), including STA-MCA bypass (39 hemispheres) and occipital artery\u2013posterior cerebral artery bypass (2 hemispheres). All patients underwent standardized perioperative management with strict blood pressure control (110-130\u00a0mmHg) based on routine single-photon emission computed tomography (SPECT) 1 and 7\u00a0days after surgery. Then we investigated the outcome of surgeries, focusing mainly on that of combined revascularization procedures.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results<\/jats:italic>\n                    : The outcome of 42 surgeries was favorable in all cases, except for one adult (2.3%) manifesting with cerebral hyperperfusion syndrome leading to neurological worsening. None of the patients developed perioperative cerebral infarction (0\/42; 0%), and the patency of the direct bypass was confirmed via MRA in all patients undergoing combined procedure (41\/41, 100%). Two patients suffered wound-healing delay, one of which required resuture.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusion<\/jats:italic>\n                    : The combined revascularization surgery is a safe and effective treatment for MMD, while local cerebral hyperperfusion is a potential complication that should be avoided through intensive perioperative care.\n                  <\/jats:p>","DOI":"10.1007\/978-3-031-89844-0_12","type":"book-chapter","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T09:42:32Z","timestamp":1752140552000},"page":"99-104","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Efficacy and Safety of Combined Revascularization Surgery for Moyamoya Disease: Standard Procedure and Perioperative Management"],"prefix":"10.1007","author":[{"given":"Miki","family":"Fujimura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruto","family":"Uchino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahito","family":"Kawabori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taku","family":"Sugiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,10]]},"reference":[{"key":"12_CR1","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1227\/NEU.0b013e3182333c47","volume":"70","author":"JS Bang","year":"2012","unstructured":"Bang JS, Kwon OK, Kim JE, Kang HS, Park H, Cho SY, Oh CW. 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Significance of focal cerebral hyperperfusion as a cause of transient neurologic deterioration after EC-IC bypass for moyamoya disease: comparative study with non-moyamoya patients using n-isopropyl-p-[(123)i]iodoamphetamine single-photon emission computed tomography. Neurosurgery. 2011;68:957\u201365.","journal-title":"Neurosurgery"},{"key":"12_CR8","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1159\/000336765","volume":"33","author":"M Fujimura","year":"2012","unstructured":"Fujimura M, Inoue T, Shimizu H, Saito A, Mugikura S, Tominaga T. Efficacy of prophylactic blood pressure lowering according to a standardized postoperative management protocol to prevent symptomatic cerebral hyperperfusion after direct revascularization surgery for moyamoya disease. 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Stroke. 2012;43:2610\u20136.","journal-title":"Stroke"}],"container-title":["Acta Neurochirurgica Supplement","Trends in the Treatment of Cerebrovascular Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/978-3-031-89844-0_12","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T07:28:51Z","timestamp":1780730931000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/978-3-031-89844-0_12"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"ISBN":["9783031898433","9783031898440"],"references-count":23,"URL":"https:\/\/doi.org\/10.1007\/978-3-031-89844-0_12","relation":{},"ISSN":["0065-1419","2197-8395"],"issn-type":[{"value":"0065-1419","type":"print"},{"value":"2197-8395","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"assertion":[{"value":"10 July 2025","order":1,"name":"first_online","label":"First Online","group":{"name":"ChapterHistory","label":"Chapter History"}},{"value":"Conflicts of interestThe authors declare that they have no conflicts of interest. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers\u2019 bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) and no nonfinancial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approvalAll procedures performed in this study were carried out in accordance with the ethical standards of the institution and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consentInformed consent was obtained from the individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"EJCVC","order":1,"name":"conference_acronym","label":"Conference Acronym","group":{"name":"ConferenceInfo","label":"Conference Information"}},{"value":"European \u2013 Japanese Cerebrovascular Congress","order":2,"name":"conference_name","label":"Conference Name","group":{"name":"ConferenceInfo","label":"Conference Information"}},{"value":"Kyoto","order":3,"name":"conference_city","label":"Conference City","group":{"name":"ConferenceInfo","label":"Conference Information"}},{"value":"Japan","order":4,"name":"conference_country","label":"Conference Country","group":{"name":"ConferenceInfo","label":"Conference Information"}},{"value":"2022","order":5,"name":"conference_year","label":"Conference Year","group":{"name":"ConferenceInfo","label":"Conference Information"}},{"value":"13 November 2022","order":7,"name":"conference_start_date","label":"Conference Start Date","group":{"name":"ConferenceInfo","label":"Conference Information"}},{"value":"16 November 2022","order":8,"name":"conference_end_date","label":"Conference End Date","group":{"name":"ConferenceInfo","label":"Conference Information"}},{"value":"ejcvc2022","order":10,"name":"conference_id","label":"Conference ID","group":{"name":"ConferenceInfo","label":"Conference Information"}},{"value":"https:\/\/site.convention.co.jp\/ejcvc2020\/","order":11,"name":"conference_url","label":"Conference URL","group":{"name":"ConferenceInfo","label":"Conference Information"}}]}}