{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T05:56:20Z","timestamp":1761630980320,"version":"3.41.2"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["SVIN"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Using a single indirect revascularization technique in adult patients with moyamoya disease has been associated with inconsistent outcomes. Herein, we aimed to describe treatment outcomes following combined encephaloduroarteriosynangiosis plus burr\u2010hole surgery (BHS) in adult moyamoya disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">Encephaloduroarteriosynangiosis combined with 1 anterior and 1 posterior burr hole per hemisphere was performed in 16 adults with moyamoya disease who presented to our center between 2013 and 2019. Patients were followed with clinical reassessments and cerebral angiograms to evaluate for neovascularization.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Combined encephaloduroarteriosynangiosis and BHS procedures were performed on 24 hemispheres in 16 patients. Follow\u2010up ranged from 9 to 57\u00a0months, during which no new ischemic or hemorrhagic events, perioperative or long\u2010term complications, or deterioration of symptoms was observed. Follow\u2010up angiography showed evidence of additional neovascularization provided by the burr holes in 18 of the 24 hemispheres. Of 9 hemispheres with poor revascularization response to encephaloduroarteriosynangiosis, 5 achieved neovascularization at the burr\u2010hole sites. Older age, smoking, and cerebral infarction or hemorrhage on preoperative magnetic resonance imaging tended to correlate with absence of neovascularization following BHS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">BHS is a simple and safe procedure that can be done simultaneously with other indirect or direct revascularization procedures. It can provide additional neovascularization even in patients unresponsive to encephaloduroarteriosynangiosis (EDAS) and can be tailored to improve the blood flow in any vascular territory that may not be properly covered by standard revascularization procedures. We find value in adding BHS as an adjunct to other indirect or direct revascularization techniques such as encephaloduroarteriosynangiosis for treatment of adult moyamoya disease.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/svin.121.000242","type":"journal-article","created":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T07:44:41Z","timestamp":1643701481000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Value of Burr\u2010Hole Surgery as an Adjunct to Encephaloduroarteriosynangiosis in Treatment of Adult Moyamoya Disease: A Case Series"],"prefix":"10.1161","volume":"2","author":[{"given":"MirHojjat","family":"Khorasanizadeh","sequence":"first","affiliation":[{"name":"Neurosurgical Service Beth Israel Deaconess Medical Center Harvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satomi","family":"Mizuhashi","sequence":"additional","affiliation":[{"name":"Neurosurgical Service Beth Israel Deaconess Medical Center Harvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher S.","family":"Ogilvy","sequence":"additional","affiliation":[{"name":"Neurosurgical Service Beth Israel Deaconess Medical Center Harvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Moore","sequence":"additional","affiliation":[{"name":"Neurosurgical Service Beth Israel Deaconess Medical Center Harvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4412-3152","authenticated-orcid":false,"given":"Ajith J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Neurosurgical Service Beth Israel Deaconess Medical Center Harvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1969.00480090076012"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1179\/1743132814Y.0000000351"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1007\/s11940-018-0511-8","article-title":"Surgical treatment of adult Moyamoya disease","volume":"20","author":"Lee SU","year":"2018","unstructured":"Lee SU, Oh CW, Kwon O\u2010K, Bang JS, Ban SP, Byoun HS, Kim T. 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Pediatr Neurosurg. 1995;23:26\u201333. https:\/\/doi.org\/10.1159\/000120932","journal-title":"Pediatr Neurosurg"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1989.71.2.0180"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199702000-00017"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2017.09.056"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000182256.32489.99"},{"key":"e_1_3_2_15_2","doi-asserted-by":"crossref","first-page":"327","DOI":"10.2176\/nmc.52.327","article-title":"Lessons learned from moyamoya disease: outcome of direct\/indirect revascularization surgery for 150 affected hemispheres","volume":"52","author":"Fujimura M","year":"2012","unstructured":"Fujimura M, Tominaga T. Lessons learned from moyamoya disease: outcome of direct\/indirect revascularization surgery for 150 affected hemispheres. Neurol Med Chir (Tokyo). 2012;52:327\u2013332. https:\/\/doi.org\/10.2176\/nmc.52.327","journal-title":"Neurol Med Chir (Tokyo)"}],"container-title":["Stroke: Vascular and Interventional Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/SVIN.121.000242","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T15:41:25Z","timestamp":1715614885000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/SVIN.121.000242"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1161\/SVIN.121.000242"],"URL":"https:\/\/doi.org\/10.1161\/svin.121.000242","relation":{},"ISSN":["2694-5746"],"issn-type":[{"type":"electronic","value":"2694-5746"}],"subject":[],"published":{"date-parts":[[2022,3]]},"assertion":[{"value":"2021-10-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e212259"}}