{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:44:49Z","timestamp":1786124689712,"version":"build-2736575974"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2018,6,17]],"date-time":"2018-06-17T00:00:00Z","timestamp":1529193600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Oper. Neurosurg.","ONSURG"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Surgical innovation is critical for the management of challenging cerebrovascular pathology. Flow-through free flaps are versatile composite grafts that combine viable tissue with a revascularization source. Neurosurgical experience with these flaps is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To provide an in-depth technical description of the radial artery fascial (and fasciocutaneous) flow-through free flap (RAFF and RAFCF, respectively) for complex cerebral revascularizations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>An Institutional Review Board-approved, prospective database was retrospectively reviewed to identify patients that underwent extracranial-to-intracranial cerebral bypass with a RAFF or RAFCF. Patient demographics, underlying pathology, surgical treatment, complications, and outcomes were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 4 patients were treated with RAFFs or RAFCFs (average age 40 \u00b1 8.8 yr). Two patients with progressive moyamoya disease involving multiple vascular territories with predominantly anterior cerebral artery (ACA) symptoms and flow alterations underwent combined direct ACA and indirect middle cerebral artery (MCA) bypass with a RAFF. The third patient with moyamoya disease and concomitant proximal fusiform aneurysms requiring internal carotid artery sacrifice underwent dual direct ACA and MCA bypass and indirect MCA revascularization with posterior tibial artery and RAFF grafts. The fourth patient with a large MCA bifurcation aneurysm and recurrent wound complications underwent a direct MCA bypass and complex wound reconstruction using a RAFCF. Good neurologic outcomes (Glasgow Outcomes Scale score \u22654 at discharge) were achieved in all patients. There were no perioperative surgical complications, and graft patency was confirmed on long-term follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The RAFF and RAFCF are versatile grafts for complex cerebral revascularizations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opy124","type":"journal-article","created":{"date-parts":[[2018,6,18]],"date-time":"2018-06-18T20:34:55Z","timestamp":1529354095000},"page":"424-434","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Radial Artery Fascial Flow-Through Free Flap for Complex Cerebral Revascularization: Technical Notes and Long-Term Neurologic and Radiographic Outcomes"],"prefix":"10.1227","volume":"16","author":[{"given":"Robert C","family":"Rennert","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of California San Diego, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Ravina","sequence":"additional","affiliation":[{"name":"Neurorestoration Center, Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben A","family":"Strickland","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Bakhsheshian","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Carey","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan J","family":"Russin","sequence":"additional","affiliation":[{"name":"Neurorestoration Center, Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,4]]},"reference":[{"issue":"1","key":"bib1-20240910","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/NRL.0000000000000086","article-title":"Urgent bypass surgery following failed endovascular treatment in acute symptomatic stroke patient with MCA occlusion","volume":"22","author":"Lee","year":"2017","journal-title":"Neurologist"},{"issue":"1","key":"bib2-20240910","doi-asserted-by":"crossref","first-page":"132","DOI":"10.3171\/jns.2005.102.1.0132","article-title":"Microsurgical anatomy of cerebral revascularization. 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