{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T18:28:50Z","timestamp":1783103330073,"version":"3.54.6"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Penn State College of Medicine Catalyst Award"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Direct cerebral bypass is a key treatment for moyamoya disease (MMD). This surgery grafts a donor vessel onto a recipient cerebral artery to boost blood flow to hypoperfused brain regions. Unlike coronary bypass, which restores downstream flow around a blockage, cerebral bypass for MMD reverses flow in the recipient vessel to perfuse the upstream network. Surgical decisions\u2014such as donor vessel choice and anastomosis angle\u2014significantly affect graft hemodynamics and outcomes. Yet these choices still rely on neurosurgeons\u2019 experience, lacking quantitative guidance. This study addresses that gap by examining how anastomosis angle shapes post-surgical perfusion and wall shear stress. We created idealized cerebral bypass models with graft angles of 30\u00b0, 60\u00b0, and 90\u00b0. Each model\u2019s flow field was assessed under varying inflow and graft-flow combinations using computational fluid dynamics. The 30\u00b0 angle produced the strongest reverse flow but also the largest WSS imbalance, potentially driving long-term complications. The 60\u00b0 angle achieved adequate reverse flow with a more uniform WSS profile, making it the most favorable. Overall, our results show graft angle must be carefully considered in cerebral bypass planning.<\/jats:p>","DOI":"10.1371\/journal.pone.0330362","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T19:00:21Z","timestamp":1767639621000},"page":"e0330362","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluating the role of graft angle on cerebral hemodynamics following direct cerebral bypass for moyamoya disease"],"prefix":"10.1371","volume":"21","author":[{"given":"Cheng","family":"Peng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ephraim W.","family":"Church","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2047-1630","authenticated-orcid":true,"given":"Melissa 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