{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T17:29:35Z","timestamp":1762018175188,"version":"build-2065373602"},"reference-count":42,"publisher":"BMJ","issue":"3","funder":[{"name":"Beijing Institute for Brain Disorders grant"},{"DOI":"10.13039\/501100004751","name":"Department of S and T for Social Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004751","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,12,20]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Revascularisation surgery is an important treatment of moyamoya disease (MMD). Several general methods of revascularisation had been used: direct, indirect and combined techniques. However, there had been no reports about the criteria of recipient arteries selection in bypass surgery for MMD. Surgeons usually choose the recipient arteries by their own experiences. Their choices of the recipient arteries are various and may contribute the different outcome of patients. The purpose is to identify utility and efficacy of precision bypass guided by multimodal neuronavigation of MMD in a prospective randomised controlled trial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method and analysis<\/jats:title>\n                  <jats:p>This study is a prospective randomised controlled clinical trial. This study will enrol a total of 100 eligible patients. These eligible patients will be randomised to the empirical bypass group and the multimodal neuronavigation-guided precision bypass group in a 1:1 ratio. Patient baseline characteristics and MMD characteristics will be described. In the multimodal neuronavigation-guided group, the blood velocity and blood flow of the recipient arteries will be identified. Surgical complications and outcomes at pretreatment, post-treatment, at discharge and at 3\u2009month, 6\u2009month, 12\u2009month and end of trial will be analysed with CT perfusion, MRI, digital subtraction angiography, modified Rankin Scale, National Institute of Health Stroke Scale and modified Barthel Scale. This trial will determine whether multimodal neuronavigation-guided precision bypass is superior to empirical bypass in patients with MMD and identify the safety and efficacy of multimodal neuronavigation-guided precision bypass.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>The study protocol and written informed consent were reviewed and approved by the Clinical Research Ethics Committee of Peking University International Hospital. Study findings will be disseminated in the printed media. The study started in August, 2018 and expected to be completed in December, 2020.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"NCT03516851\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial pre-results\">NCT03516851<\/jats:ext-link>; Pre-results.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-025566","type":"journal-article","created":{"date-parts":[[2019,3,21]],"date-time":"2019-03-21T05:37:20Z","timestamp":1553146640000},"page":"e025566","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Multimodal neuronavigation-guided precision bypass in adult ischaemic patients with moyamoya disease: study protocol for a randomised controlled trial"],"prefix":"10.1136","volume":"9","clinical-trial-number":[{"clinical-trial-number":"nct03516851","registry":"10.18810\/clinical-trials-gov","type":"preResults"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4879-0729","authenticated-orcid":false,"given":"Junlin","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital , Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yahui","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital , Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital , Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital , Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingtao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital , Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xun","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital , Capital Medical University, Beijing, China"},{"name":"Department of Neurosurgery, PekingUniversity International Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital , Capital Medical University, Beijing, China"},{"name":"Department of Neurosurgery, PekingUniversity International Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaolin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital , Capital Medical University, Beijing, China"},{"name":"Department of Neurosurgery, PekingUniversity International Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanli","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital , Capital Medical University, Beijing, China"},{"name":"Department of Neurosurgery, PekingUniversity International Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,3,20]]},"reference":[{"key":"2025101811254923000_9.3.e025566.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70240-0"},{"key":"2025101811254923000_9.3.e025566.2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.29.7.1347"},{"key":"2025101811254923000_9.3.e025566.3","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2011-301387"},{"key":"2025101811254923000_9.3.e025566.4","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000176066.33797.82"},{"issue":"Suppl 2","key":"2025101811254923000_9.3.e025566.5","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.1016\/S0303-8467(97)00037-1","article-title":"A survey of moyamoya disease in Hawaii","volume":"99","author":"Graham","year":"1997","journal-title":"Clin Neurol Neurosurg"},{"key":"2025101811254923000_9.3.e025566.6","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.004160"},{"key":"2025101811254923000_9.3.e025566.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2009.11.009"},{"key":"2025101811254923000_9.3.e025566.8","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1789.2000.00300.x"},{"key":"2025101811254923000_9.3.e025566.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0804622"},{"key":"2025101811254923000_9.3.e025566.10","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1093\/neuros\/nyx140","article-title":"Berlin grading system can stratify the onset and predict perioperative complications in adult moyamoya disease","volume":"81","author":"Kashiwazaki","year":"2017","journal-title":"Neurosurgery"},{"key":"2025101811254923000_9.3.e025566.11","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.3171\/2017.2.JNS162405","article-title":"Direct versus indirect bypasses for adult ischemic-type moyamoya disease: a propensity score-matched analysis","volume":"128","author":"Deng","year":"2018","journal-title":"J Neurosurg"},{"key":"2025101811254923000_9.3.e025566.12","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.013304"},{"key":"2025101811254923000_9.3.e025566.13","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.3171\/2016.12.JNS162626","article-title":"Effects of different surgical modalities on the clinical outcome of patients with moyamoya disease: a prospective cohort study","volume":"128","author":"Deng","year":"2018","journal-title":"J Neurosurg"},{"key":"2025101811254923000_9.3.e025566.14","doi-asserted-by":"publisher","DOI":"10.3171\/2014.1.JNS13946"},{"key":"2025101811254923000_9.3.e025566.15","doi-asserted-by":"crossref","unstructured":"Zhao M , Deng X , Zhang D , et al . Risk factors for and outcomes of postoperative complications in adult patients with moyamoya disease. J Neurosurg 2018:1\u201312.doi:10.3171\/2017.10.JNS171749","DOI":"10.1093\/neuros\/nyy303.101"},{"key":"2025101811254923000_9.3.e025566.16","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.621300"},{"key":"2025101811254923000_9.3.e025566.17","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.11.2272"},{"key":"2025101811254923000_9.3.e025566.18","doi-asserted-by":"crossref","first-page":"392","DOI":"10.3171\/2014.10.JNS132369","article-title":"Clinical features and long-term outcomes of moyamoya disease: a single-center experience with 528 cases in China","volume":"122","author":"Liu","year":"2015","journal-title":"J Neurosurg"},{"key":"2025101811254923000_9.3.e025566.19","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2000.93.6.0976"},{"issue":"Suppl 2","key":"2025101811254923000_9.3.e025566.20","doi-asserted-by":"crossref","first-page":"S194","DOI":"10.1016\/S0303-8467(97)00078-4","article-title":"The efficacy of bypass surgery for the patients with hemorrhagic moyamoya disease","volume":"99","author":"Fujii","year":"1997","journal-title":"Clin Neurol Neurosurg"},{"key":"2025101811254923000_9.3.e025566.21","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000058223.73857.F4"},{"key":"2025101811254923000_9.3.e025566.22","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1978.49.5.0679"},{"issue":"Suppl 2","key":"2025101811254923000_9.3.e025566.23","doi-asserted-by":"crossref","first-page":"S134","DOI":"10.1016\/S0303-8467(97)00074-7","article-title":"Superficial temporal artery to anterior cerebral artery direct anastomosis in patients with moyamoya disease","volume":"99","author":"Iwama","year":"1997","journal-title":"Clin Neurol Neurosurg"},{"key":"2025101811254923000_9.3.e025566.24","doi-asserted-by":"crossref","first-page":"462","DOI":"10.2176\/nmc.46.462","article-title":"Simultaneous superficial temporal artery to middle cerebral or anterior cerebral artery bypass with pan-synangiosis for Moyamoya disease covering both anterior and middle cerebral artery territories","volume":"46","author":"Ishikawa","year":"2006","journal-title":"Neurol Med Chir"},{"key":"2025101811254923000_9.3.e025566.25","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8249(200001)47:1<93::AID-ANA15>3.0.CO;2-8"},{"key":"2025101811254923000_9.3.e025566.26","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.31.3.680"},{"key":"2025101811254923000_9.3.e025566.27","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.50.3.633"},{"key":"2025101811254923000_9.3.e025566.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2012.05.010"},{"key":"2025101811254923000_9.3.e025566.29","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-013-1155-8"},{"key":"2025101811254923000_9.3.e025566.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2011.01.016"},{"key":"2025101811254923000_9.3.e025566.31","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.23613"},{"key":"2025101811254923000_9.3.e025566.32","doi-asserted-by":"crossref","first-page":"14822","DOI":"10.1038\/s41598-017-05913-w","article-title":"Application of multimodal navigation together with fluorescein angiography in microsurgical treatment of cerebral arteriovenous malformations","volume":"7","author":"Feng","year":"2017","journal-title":"Sci Rep"},{"key":"2025101811254923000_9.3.e025566.33","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.jcms.2015.03.013","article-title":"Assessment of free microvascular flap perfusion by intraoperative fluorescence angiography in craniomaxillofacial surgery","volume":"43","author":"Preidl","year":"2015","journal-title":"J Craniomaxillofac Surg"},{"key":"2025101811254923000_9.3.e025566.34","first-page":"309","article-title":"[Efficacy of indocyanine green videoangiography for carotid endarterectomy]","volume":"40","author":"Okawa","year":"2012","journal-title":"No Shinkei Geka"},{"key":"2025101811254923000_9.3.e025566.35","doi-asserted-by":"crossref","first-page":"4232","DOI":"10.3760\/cma.j.issn.0366-6999.20131649","article-title":"Clinical values of intraoperative indocyanine green fluorescence video angiography with Flow 800 software in cerebrovascular surgery","volume":"126","author":"Ye","year":"2013","journal-title":"Chin Med J"},{"key":"2025101811254923000_9.3.e025566.36","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-868161"},{"key":"2025101811254923000_9.3.e025566.37","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2351031663"},{"key":"2025101811254923000_9.3.e025566.38","doi-asserted-by":"publisher","DOI":"10.1097\/RCT.0b013e31824150dd"},{"key":"2025101811254923000_9.3.e025566.39","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-014-3098-9"},{"key":"2025101811254923000_9.3.e025566.40","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1007\/s00701-010-0911-3","article-title":"Typical 3-D localization of tumor remnants of WHO grade II hemispheric gliomas--lessons learned from the use of intraoperative high-field MRI control","volume":"153","author":"Gerganov","year":"2011","journal-title":"Acta Neurochir"},{"key":"2025101811254923000_9.3.e025566.41","doi-asserted-by":"publisher","DOI":"10.3171\/FOC\/2008\/24\/2\/E15"},{"key":"2025101811254923000_9.3.e025566.42","doi-asserted-by":"publisher","DOI":"10.1016\/j.surneu.2006.07.017"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-025566","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T18:26:02Z","timestamp":1760811962000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-025566"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":42,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,3,20]]},"published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1136\/bmjopen-2018-025566"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-025566","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2019,3]]}}}