{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T23:04:20Z","timestamp":1780700660796,"version":"3.54.1"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Plast Surg"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cerebrovascular revascularization for moyamoya disease remains one of the most technically demanding procedures in neurosurgery, requiring meticulous microvascular anastomosis and precise intraoperative execution. The success of these operations depends on advanced microsurgical skill, careful teamwork, and refined perioperative planning. This review outlines the emerging neuroplastic approach\u2014a collaborative model between neurosurgeons and plastic microsurgeons\u2014and its integration with augmented reality (AR) technologies to enhance surgical precision, planning, and education. Drawing on recent evidence, neuroplastic collaboration improves graft patency, reduces ischemic complications, and shortens hospital stay in moyamoya revascularization. Parallel advances in AR enable immersive three-dimensional visualization, microvascular simulation, and intraoperative guidance. The combined neuroplastic\u2013AR workflow enhances surgical accuracy, training efficiency, and patient safety, offering a sustainable framework for the next generation of cerebral revascularization.<\/jats:p>","DOI":"10.1055\/a-2842-2242","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T22:40:31Z","timestamp":1780699231000},"page":"133-138","source":"Crossref","is-referenced-by-count":0,"title":["Neuroplastic and Augmented Reality Integration in Moyamoya Revascularization: A Reconstructive Microsurgical Paradigm"],"prefix":"10.1055","volume":"40","author":[{"given":"Chieh-Tsai","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Hung","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung-Kan","family":"Tsao","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yau-Zen","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.wneu.2015.03.005","article-title":"Augmented reality-enhanced navigation for extracranial-intracranial bypass","volume":"84","author":"R O Almefty","year":"2015","journal-title":"World Neurosurg"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"679","DOI":"10.3171\/jns.1978.49.5.0679","article-title":"Treatment of moyamoya disease with STA-MCA anastomosis","volume":"49","author":"J Karasawa","year":"1978","journal-title":"J Neurosurg"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"E7","DOI":"10.3171\/2009.01.FOCUS08293","article-title":"Surgical management of moyamoya disease: a review","volume":"26","author":"A A Baaj","year":"2009","journal-title":"Neurosurg Focus"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"189","DOI":"10.2176\/nmc.ra.2014-0307","article-title":"Diagnosis of moyamoya disease: international standard and regional differences","volume":"55","author":"M Fujimura","year":"2015","journal-title":"Neurol Med Chir (Tokyo)"},{"issue":"08","key":"ref5","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/S1474-4422(22)00165-X","article-title":"Moyamoya disease: diagnosis and interventions","volume":"21","author":"M Ihara","year":"2022","journal-title":"Lancet Neurol"},{"issue":"01","key":"ref6","first-page":"58","article-title":"Stroke in Asia","volume":"14","author":"K S Tan","year":"2024","journal-title":"Cerebrovasc Dis Extra"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"e2415102","DOI":"10.1001\/jamanetworkopen.2024.15102","article-title":"Outcomes of bypass surgery in adult moyamoya disease by onset type","volume":"7","author":"Y C Lim","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1055\/s-0044-1786759","article-title":"Neuroplastic surgery principles of computerized surgical planning in complex cranioplasty reconstruction","volume":"38","author":"C F Perez","year":"2024","journal-title":"Semin Plast Surg"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s00701-025-06462-2","article-title":"Neuroplastics approach to cerebrovascular bypass surgery: the way forward for centres with small to medium volume caseload","volume":"167","author":"J X Lim","year":"2025","journal-title":"Acta Neurochir (Wien)"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"100822","DOI":"10.1016\/j.bj.2024.100822","article-title":"Application of extended reality in pediatric neurosurgery: a comprehensive review","volume":"48","author":"Y Z Chang","year":"2025","journal-title":"Biomed J"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1161\/01.STR.14.1.104","article-title":"Moyamoya disease\u2014a review","volume":"14","author":"J Suzuki","year":"1983","journal-title":"Stroke"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/978-3-031-89844-0_12","article-title":"Efficacy and safety of combined revascularization surgery for moyamoya disease: standard procedure and perioperative management","volume":"136","author":"M Fujimura","year":"2025","journal-title":"Acta Neurochir Suppl (Wien)"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1093\/neuros\/nyab156","article-title":"Direct vs indirect revascularization in a North American cohort of moyamoya disease","volume":"89","author":"P MR Lai","year":"2021","journal-title":"Neurosurgery"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.3171\/2022.8.JNS22336","article-title":"Short- and long-term outcomes of moyamoya patients post-revascularization","volume":"138","author":"M Teo","year":"2022","journal-title":"J Neurosurg"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"e189","DOI":"10.1016\/j.wneu.2020.03.170","article-title":"Development and evaluation of pediatric mixed-reality model for neuroendoscopic surgical training","volume":"139","author":"G Coelho","year":"2020","journal-title":"World Neurosurg"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"e299","DOI":"10.1016\/j.wneu.2020.02.098","article-title":"The craniosynostosis puzzle: new simulation model for neurosurgical training","volume":"138","author":"G Coelho","year":"2020","journal-title":"World Neurosurg"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"470","DOI":"10.3390\/jcm11020470","article-title":"XR (extended reality: virtual reality, augmented reality, mixed reality) technology in spine medicine: status quo and quo vadis","volume":"11","author":"T Morimoto","year":"2022","journal-title":"J Clin Med"},{"issue":"03","key":"ref18","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.3390\/app13031629","article-title":"Augmented reality in surgical navigation: a review of evaluation and validation metrics","volume":"13","author":"S Malhotra","year":"2023","journal-title":"Appl Sci (Basel)"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"102361","DOI":"10.1016\/j.media.2022.102361","article-title":"Utility of optical see-through head mounted displays in augmented reality-assisted surgery: a systematic review","volume":"77","author":"M Birlo","year":"2022","journal-title":"Med Image Anal"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"102283","DOI":"10.1016\/j.displa.2022.102283","article-title":"Optical see-through augmented reality can induce severe motion sickness","volume":"74","author":"M Kaufeld","year":"2022","journal-title":"Displays"},{"issue":"01","key":"ref21","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s41205-025-00251-4","article-title":"Microsoft HoloLens 2 vs. tablet-based augmented reality and 3D printing for fronto-orbital reconstruction of craniosynostosis: a case study","volume":"11","author":"A Pose-Diez-de-la-Lastra","year":"2025","journal-title":"3D Print Med"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.jss.2023.12.014","article-title":"Augmented reality guided laparoscopic liver resection: a phantom study with intraparenchymal tumors","volume":"296","author":"M Ribeiro","year":"2024","journal-title":"J Surg Res"},{"issue":"04","key":"ref23","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1093\/ons\/opz176","article-title":"Augmented reality in superficial temporal artery to middle cerebral artery bypass surgery: technical note","volume":"18","author":"J Rychen","year":"2020","journal-title":"Oper Neurosurg (Hagerstown)"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"E13","DOI":"10.3171\/2023.10.FOCUS23613","article-title":"Innovations in craniovertebral junction training: harnessing the power of mixed reality and head-mounted displays","volume":"56","author":"A Ganeshkumar","year":"2024","journal-title":"Neurosurg Focus"},{"issue":"03","key":"ref25","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1136\/jnis-2023-020797","article-title":"Feasibility and workflow analysis of IV-DSA-based augmented reality-guided brain arteriovenous malformation resection in a hybrid operating room: i-Flow tailored method","volume":"17","author":"C W Huang","year":"2025","journal-title":"J Neurointerv Surg"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jocn.2021.09.037","article-title":"Examining the benefits of extended reality in neurosurgery: a systematic review","volume":"94","author":"N B Dadario","year":"2021","journal-title":"J Clin Neurosci"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"124632","DOI":"10.1016\/j.wneu.2025.124632","article-title":"Augmented and virtual reality in open neurovascular surgery: a systematic review of the literature","volume":"205","author":"A Saemann","year":"2026","journal-title":"World Neurosurg"},{"key":"ref28","first-page":"179","article-title":"Multidisciplinary approach for improved outcomes in secondary cranial reconstruction: introducing the pericranial-onlay cranioplasty technique","volume":"10","author":"C R Gordon","year":"2014","journal-title":"Neurosurgery"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"e416","DOI":"10.1016\/j.wneu.2020.12.072","article-title":"Patient-specific three-dimensional printing guide for single-stage skull bone tumor surgery: novel software workflow with manufacturing of prefabricated jigs for bone resection and reconstruction","volume":"147","author":"C-T Wu","year":"2021","journal-title":"World Neurosurg"},{"issue":"02","key":"ref30","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1159\/000113116","article-title":"Computer-aided design for three-dimensional titanium mesh used for repairing skull base bone defect in pediatric neurofibromatosis type 1. A novel approach combining biomodeling and neuronavigation","volume":"44","author":"C T Wu","year":"2008","journal-title":"Pediatr Neurosurg"},{"issue":"01","key":"ref31","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/SCS.0000000000006883","article-title":"The special field of neuroplastic surgery","volume":"32","author":"C R Gordon","year":"2021","journal-title":"J Craniofac Surg"},{"issue":"07","key":"ref32","doi-asserted-by":"crossref","first-page":"2371","DOI":"10.1097\/SCS.0000000000011729","article-title":"Evolving neurosurgery-neuroplastic and reconstructive surgery: a narrative review","volume":"36","author":"T J Somorin","year":"2025","journal-title":"J Craniofac Surg"},{"issue":"01","key":"ref33","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1097\/SCS.0000000000007201","article-title":"The neuroplastic surgery fellowship experience: where tradition meets innovation","volume":"32","author":"K S Mitchell","year":"2021","journal-title":"J Craniofac Surg"}],"container-title":["Seminars in Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2842-2242.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T22:40:43Z","timestamp":1780699243000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2842-2242"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":33,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2026,6,5]]},"published-print":{"date-parts":[[2026,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2842-2242","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1535-2188","1536-0067"],"issn-type":[{"value":"1535-2188","type":"print"},{"value":"1536-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}