{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T18:31:16Z","timestamp":1792693876808,"version":"4.5.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>The surgical outcomes of adult moyamoya disease are rarely reported. We aimed to evaluate the long-term outcomes of combined revascularization surgery in patients with adult moyamoya disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>Combined revascularization surgery consisting of superficial temporal artery\u2013middle cerebral artery anastomosis with encephalodurogaleosynangiosis was performed on 77 hemispheres in 60 patients. Clinical, angiographic, and hemodynamic states were evaluated retrospectively using quantitative methods preoperatively and postoperatively in the short-term (\u22486 months) and long-term (\u22485 years) periods. The mean clinical follow-up duration was 71.0\u00b110.1 months (range, 60\u2013104 months).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              Clinical status improved until 6 months after surgery and remained stable thereafter, as assessed by the Karnofsky Performance Scale and modified Rankin Scale. The revascularization area relative to supratentorial area significantly increased in the long-term period compared with that in the short-term period (54.8% versus 44.2%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Cerebral blood flow in the territory of the middle cerebral artery improved in the short-term period compared with that in the preoperative period (68.7 versus 59.1; considering blood flow of the pons as 50;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and thereafter became stable (65.5 in the long term;\n              <jats:italic>P<\/jats:italic>\n              =0.219). The annual risks of symptomatic hemorrhage and infarction were 0.4% and 0.2%, respectively, in the operated hemispheres.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Combined revascularization surgery resulted in satisfactory long-term improvement in clinical, angiographic, and hemodynamic states and prevention of recurrent stroke.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.114.005624","type":"journal-article","created":{"date-parts":[[2014,9,3]],"date-time":"2014-09-03T14:15:07Z","timestamp":1409753707000},"page":"3025-3031","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":168,"title":["Long-Term Outcomes After Combined Revascularization Surgery in Adult Moyamoya Disease"],"prefix":"10.1161","volume":"45","author":[{"given":"Won-Sang","family":"Cho","sequence":"first","affiliation":[{"name":"From the Departments of Neurosurgery (W.-S.C., J.E.K., C.H.K., S.P.B., H.-S.K., Y.J.S., J.S.B., C.W.O.), Radiology (C.-H.S.), and Nuclear Medicine (J.C.P.), Seoul National University College of Medicine, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Eun","family":"Kim","sequence":"additional","affiliation":[{"name":"From the Departments of Neurosurgery (W.-S.C., J.E.K., C.H.K., S.P.B., H.-S.K., Y.J.S., J.S.B., C.W.O.), Radiology (C.-H.S.), and Nuclear Medicine (J.C.P.), Seoul National University College of Medicine, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang Hyeun","family":"Kim","sequence":"additional","affiliation":[{"name":"From the Departments of Neurosurgery (W.-S.C., J.E.K., C.H.K., S.P.B., H.-S.K., Y.J.S., J.S.B., C.W.O.), Radiology (C.-H.S.), and Nuclear Medicine (J.C.P.), Seoul National University College of Medicine, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Pil","family":"Ban","sequence":"additional","affiliation":[{"name":"From the Departments of Neurosurgery (W.-S.C., J.E.K., C.H.K., S.P.B., H.-S.K., Y.J.S., J.S.B., C.W.O.), Radiology (C.-H.S.), and Nuclear Medicine (J.C.P.), Seoul National University College of Medicine, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun-Seung","family":"Kang","sequence":"additional","affiliation":[{"name":"From the Departments of Neurosurgery (W.-S.C., J.E.K., C.H.K., S.P.B., H.-S.K., Y.J.S., J.S.B., C.W.O.), Radiology (C.-H.S.), and Nuclear Medicine (J.C.P.), Seoul National University College of Medicine, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Je","family":"Son","sequence":"additional","affiliation":[{"name":"From the Departments of Neurosurgery (W.-S.C., J.E.K., C.H.K., S.P.B., H.-S.K., Y.J.S., J.S.B., C.W.O.), Radiology (C.-H.S.), and Nuclear Medicine (J.C.P.), Seoul National University College of Medicine, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Seung","family":"Bang","sequence":"additional","affiliation":[{"name":"From the Departments of Neurosurgery (W.-S.C., J.E.K., C.H.K., S.P.B., H.-S.K., Y.J.S., J.S.B., C.W.O.), Radiology (C.-H.S.), and Nuclear Medicine (J.C.P.), Seoul National University College of Medicine, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chul-Ho","family":"Sohn","sequence":"additional","affiliation":[{"name":"From the Departments of Neurosurgery (W.-S.C., J.E.K., C.H.K., S.P.B., H.-S.K., Y.J.S., J.S.B., C.W.O.), Radiology (C.-H.S.), and Nuclear Medicine (J.C.P.), Seoul National University College of Medicine, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Chul","family":"Paeng","sequence":"additional","affiliation":[{"name":"From the Departments of Neurosurgery (W.-S.C., J.E.K., C.H.K., S.P.B., H.-S.K., Y.J.S., J.S.B., C.W.O.), Radiology (C.-H.S.), and Nuclear Medicine (J.C.P.), Seoul National University College of Medicine, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang Wan","family":"Oh","sequence":"additional","affiliation":[{"name":"From the Departments of Neurosurgery (W.-S.C., J.E.K., C.H.K., S.P.B., H.-S.K., Y.J.S., J.S.B., C.W.O.), Radiology (C.-H.S.), and Nuclear Medicine (J.C.P.), Seoul National University College of Medicine, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.14.1.104"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000221787.70503.ca"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21981"},{"key":"e_1_3_3_5_2","first-page":"142","article-title":"Long-term outcome in children with moyamoya syndrome after cranial revascularization by pial synangiosis.","volume":"100","author":"Scott 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